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Randomized trials of replacing saturated fatty acids with n-6 polyunsaturated fatty acids in coronary heart disease prevention: Not the gold standard?

Virtanen JK.

Prostaglandins Leukot Essent Fatty Acids. 2018 Jun;133:8-15. doi: 10.1016/j.plefa.2018.04.002. Epub 2018 Apr 26. Review.

PMID: 29789131

Abstract

Several trials in the 1950s through 1970s tested the hypothesis that replacing saturated fat in the diet predominantly with n-6 polyunsaturated fat (PUFA) would reduce the incidence of coronary heart disease (CHD), mainly through modifying blood lipid profile. Most of these trials did observe a reduction in serum total cholesterol in the intervention group, but many trials failed to find a significant reduction in the incidence of CHD. However, some meta-analyses have found a reduced incidence of CHD by pooling the results from the trials. Recently, new recovered and reanalyzed data has emerged from two of the old trials. The new findings seemed to counteract the classical diet-heart hypothesis, when they found no cardiovascular benefit and even suggested harm, despite reduction in the serum total cholesterol concentration after replacing saturated fat especially with n-6 PUFA. This has raised criticism regarding the validity of the dietary recommendations that suggest partially replacing saturated fats with n-6 PUFA. This paper introduces the classical diet-heart trials and their main results and how the new findings relate to the overall study data of the cardiovascular effects of the n-6 PUFA. For multiple reasons considered here, it is difficult to draw firm conclusions of the cardiovascular effects of the n-6 PUFA based only on the findings in the old diet-heart trials. A more comprehensive picture emerges when also other lines of evidence is considered. The overall study data, including findings also from prospective cohort studies and from dietary trials with intermediate outcomes, still suggests that replacing saturated fat with n-6 PUFA would rather be beneficial than harmful for the prevention of CHD.

KEYWORDS:

Clinical trials; Coronary heart disease; Diet-heart hypothesis; Polyunsaturated fatty acids; Prevention; Saturated fatty acids

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Associations of discretionary screen time with mortality, cardiovascular disease and cancer are attenuated by strength, fitness and physical activity: findings from the UK Biobank study.

Celis-Morales CA, Lyall DM, Steell L, Gray SR, Iliodromiti S, Anderson J, Mackay DF, Welsh P, Yates T, Pell JP, Sattar N, Gill JMR.

BMC Med. 2018 May 24;16(1):77. doi: 10.1186/s12916-018-1063-1.

PMID: 29792209

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1063-1

Abstract

BACKGROUND:

Discretionary screen time (time spent viewing a television or computer screen during leisure time) is an important contributor to total sedentary behaviour, which is associated with increased risk of mortality and cardiovascular disease (CVD). The aim of this study was to determine whether the associations of screen time with cardiovascular disease and all-cause mortality were modified by levels of cardiorespiratory fitness, grip strength or physical activity.

METHODS:

In total, 390,089 participants (54% women) from the UK Biobank were included in this study. All-cause mortality, CVD and cancer incidence and mortality were the main outcomes. Discretionary television (TV) viewing, personal computer (PC) screen time and overall screen time (TV + PC time) were the exposure variables. Grip strength, fitness and physical activity were treated as potential effect modifiers.

RESULTS:

Altogether, 7420 participants died, and there were 22,210 CVD events, over a median of 5.0 years follow-up (interquartile range 4.3 to 5.7; after exclusion of the first 2 years from baseline in the landmark analysis). All discretionary screen-time exposures were significantly associated with all health outcomes. The associations of overall discretionary screen time with all-cause mortality and incidence of CVD and cancer were strongest amongst participants in the lowest tertile for grip strength (all-cause mortality hazard ratio per 2-h increase in screen time (1.31 [95% confidence interval: 1.22-1.43], p < 0.0001; CVD 1.21 [1.13-1.30], p = 0.0001; cancer incidence 1.14 [1.10-1.19], p < 0.0001) and weakest amongst those in the highest grip-strength tertile (all-cause mortality 1.04 [0.95-1.14], p = 0.198; CVD 1.05 [0.99-1.11], p = 0.070; cancer 0.98 [0.93-1.05], p = 0.771). Similar trends were found for fitness (lowest fitness tertile: all-cause mortality 1.23 [1.13-1.34], p = 0.002 and CVD 1.10 [1.02-1.22], p = 0.010; highest fitness tertile: all-cause mortality 1.12 [0.96-1.28], p = 0.848 and CVD 1.01 [0.96-1.07], p = 0.570). Similar findings were found for physical activity for all-cause mortality and cancer incidence.

CONCLUSIONS:

The associations between discretionary screen time and adverse health outcomes were strongest in those with low grip strength, fitness and physical activity and markedly attenuated in those with the highest levels of grip strength, fitness and physical activity. Thus, if these associations are causal, the greatest benefits from health promotion interventions to reduce discretionary screen time may be seen in those with low levels of strength, fitness and physical activity.

KEYWORDS:

Cardiovascular; Fitness; Mortality; Physical activity; Screen time; Screen-time; Strength

 

Reduced expression of C/EBPβ-LIP extends health- and lifespan in mice.

Müller C, Zidek LM, Ackermann T, de Jong T, Liu P, Kliche V, Zaini MA, Kortman G, Harkema L, Verbeek DS, Tuckermann JP, von Maltzahn J, de Bruin A, Guryev V, Wang ZQ, Calkhoven CF.

Elife. 2018 Apr 30;7. pii: e34985. doi: 10.7554/eLife.34985. [Epub ahead of print]

PMID: 29708496 Free Article

https://cdn.elifesciences.org/articles/34985/elife-34985-v1.pdf

Abstract

Ageing is associated with physical decline and the development of age-related diseases such as metabolic disorders and cancer. Few conditions are known that attenuate the adverse effects of ageing, including calorie restriction (CR) and reduced signalling through the mechanistic target of rapamycin complex 1 (mTORC1) pathway. Synthesis of the metabolic transcription factor C/EBPβ-LIP is stimulated by mTORC1, which critically depends on a short upstream open reading frame (uORF) in the Cebpb-mRNA. Here we describe that reduced C/EBPβ-LIP expression due to genetic ablation of the uORF delays the development of age-associated phenotypes in mice. Moreover, female C/EBPβΔuORF mice display an extended lifespan. Since LIP levels increase upon aging in wild type mice, our data reveal an important role for C/EBPβ in the aging process and suggest that restriction of LIP expression sustains health and fitness. Thus, therapeutic strategies targeting C/EBPβ-LIP may offer new possibilities to treat age-related diseases and to prolong healthspan.

KEYWORDS:

cell biology; chromosomes; gene expression; mouse

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Food deprivation increases hepatic hepcidin expression and can overcome the effect of Hfe deletion in male mice.

Mirciov CSG, Wilkins SJ, Anderson GJ, Frazer DM.

FASEB J. 2018 May 25:fj201701497RR. doi: 10.1096/fj.201701497RR. [Epub ahead of print]

PMID: 29799786

Abstract

Iron-loading disorders, such as hereditary hemochromatosis, are associated with inappropriately low expression of the iron regulatory hormone, hepcidin. A recent study has demonstrated that food deprivation can increase hepcidin production in mice. We have examined this effect in more detail to determine whether the pathway(s) that are responsible might provide novel targets for pharmaceutical intervention in disorders of iron homeostasis. C57BL/6 mice were deprived of food for 5, 10, 16, or 24 h before euthanasia, then blood and tissue samples were collected for analysis. The effect of food deprivation was also examined in Hfe-/- mice, a model of hereditary hemochromatosis, as well as mice that were maintained on an iron-deficient diet or injected with erythropoietin. Food deprivation increased the hepatic expression of the gene that encodes hepcidin, hepcidin antimicrobial peptide 1 ( Hamp1), with maximal expression observed after 16 h, and was able to overcome the reduction in Hamp1 expression associated with Hfe deficiency. Food deprivation also increased Hamp1 expression in response to stimuli that more strongly suppress the gene, such as iron deficiency and erythropoietin treatment, but the effects were not significant. These results indicate that Hamp1 induction by food deprivation is independent of HFE and suggest that targeting the pathway regulated by food deprivation could have clinical benefit in iron-loading conditions.-Mirciov, C. S. G., Wilkins, S. J., Anderson, G. J., Frazer, D. M. Food deprivation increases hepatic hepcidin expression and can overcome the effect of Hfe deletion in male mice.

KEYWORDS:

Hamp; hereditary hemochromatosis; iron deficiency; stimulated erythropoiesis

 

The effects of advanced glycation end products (AGEs) on dermal wound healing and scar formation: a systematic review.

Van Putte L, De Schrijver S, Moortgat P.

Scars Burn Heal. 2016 Dec 5;2:2059513116676828. doi: 10.1177/2059513116676828. eCollection 2016 Jan-Dec. Review.

PMID: 29799552

Abstract

INTRODUCTION:

With ageing, the skin gradually loses its youthful appearance and functions like wound healing and scar formation. The pathophysiological theory of Advanced Glycation End products (AGEs) has gained traction during the last decade. This review aims to document the influence of AGEs on the mechanical and physiologic properties of the skin, how they affect dermal wound healing and scar formation in high-AGE populations like elderly patients and diabetics, and potential therapeutic strategies.

METHODS:

This systematic literature study involved a structured search in Pubmed and Web of Science with qualitative analysis of 14 articles after a three-staged selection process with the use of in- and exclusion criteria.

RESULTS:

Overall, AGEs cause shortened, thinned, and disorganized collagen fibrils, consequently reducing elasticity and skin/scar thickness with increased contraction and delayed wound closure. Documented therapeutic strategies include dietary AGE restriction, sRAGE decoy receptors, aminoguanidine, RAGE-blocking antibodies, targeted therapy, thymosin β4, anti-oxidant agents and gold nanoparticles, ethyl pyruvate, Gal-3 manipulation and metformin.

DISCUSSION:

With lack of evidence concerning scars, no definitive conclusions can yet be made about the role of AGEs on possible appearance or function of scar tissue. However, all results suggest that scars tend to be more rigid and contractile with persistent redness and reduced tendency towards hypertrophy as AGEs accumulate.

CONCLUSION:

Abundant evidence supports the pathologic role of AGEs in ageing and dermal wound healing and the effectiveness of possible therapeutic agents. More research is required to conclude its role in scar formation and scar therapy.

KEYWORDS:

Advanced glycosylation end products (AGEs); cicatrix; connective tissue; dermal wound healing; fibrosis; photoageing; scarring; skin ageing

 

Evidence supporting a mechanistic role of sirtuins in mood and metabolic disorders.

Alageel A, Tomasi J, Tersigni C, Brietzke E, Zuckerman H, Subramaniapillai M, Lee Y, Iacobucci M, Rosenblat JD, Mansur RB, McIntyre RS.

Prog Neuropsychopharmacol Biol Psychiatry. 2018 May 23. pii: S0278-5846(18)30156-8. doi: 10.1016/j.pnpbp.2018.05.017. [Epub ahead of print] Review.

PMID: 29802856

Abstract

Sirtuins are NAD+-dependent histone deacetylases that play essential roles in cell survival, energy metabolism, inflammation, and aging; therefore, sirtuins are potential therapeutic targets in the treatment of type 2 diabetes, cancer, inflammatory and metabolic disorders, and neurodegenerative diseases. Available evidence provides the basis for hypothesizing that sirtuins 1, 2, and 3 (SIRT1, SIRT2, and SIRT3) may have a mechanistic role subserving mood disorders (i.e. downregulation) and associated co-morbidity (e.g. metabolic disorders). Specifically, the domains of general cognitive processes, as well as cognitive emotional processing may be particularly relevant to sirtuin physiology. Given the role of sirtuins in the perpetuation of circadian rhythmicity, and evidence of dysfunctional circadian cycling in mood disorders, sirtuins may be an underlying etiological factor that links circadian rhythm functionality with mood disorders. Caloric restriction, and caloric restriction mimetics (e.g. resveratrol) are all capable of upregulating sirtuin isoforms implicated in stress response syndromes. Repurposing existing treatments and/or discovery of novel agents capable of modulating sirtuin physiology may represent genuinely novel approaches for trans-diagnostic domains affected in mood disorders and other brain-based illnesses.

KEYWORDS:

Bipolar; Depression; Disorder; Metabolic; Mood; Sirtuins

 

The Super-Seniors Study: Phenotypic characterization of a healthy 85+ population.

Halaschek-Wiener J, Tindale LC, Collins JA, Leach S, McManus B, Madden K, Meneilly G, Le ND, Connors JM, Brooks-Wilson AR.

PLoS One. 2018 May 24;13(5):e0197578. doi: 10.1371/journal.pone.0197578. eCollection 2018.

PMID: 29795606

Abstract

BACKGROUND:

To understand why some people live to advanced age in good health and others do not, it is important to study not only disease, but also long-term good health. The Super-Seniors Study aims to identify factors associated with healthy aging.

METHODS:

480 healthy oldest-old 'Super-Seniors' aged 85 to 105 years and never diagnosed with cancer, cardiovascular disease, diabetes, dementia, or major pulmonary disease, were compared to 545 mid-life controls aged 41-54, who represent a group that is unselected for survival from late-life diseases. Health and lifestyle information, personal and family medical history, and blood samples were collected from all participants. Super-Seniors also underwent four geriatric tests.

RESULTS:

Super-Seniors showed high cognitive (Mini-Mental State Exam mean = 28.3) and functional capacity (Instrumental Activities of Daily Living Scale mean = 21.4), as well as high physical function (Timed Up and Go mean = 12.3 seconds) and low levels of depression (Geriatric Depression Scale mean = 1.5). Super-Seniors were less likely to be current smokers than controls, but the frequency of drinking alcohol was the same in both groups. Super-Seniors were more likely to have 4 or more offspring; controls were more likely to have no children. Female Super-Seniors had a mean age of last fertility 1.9 years older than controls, and were 2.3 times more likely to have had a child at ≥ 40 years. The parents of Super-Seniors had mean ages of deaths of 79.3 years for mothers, and 74.5 years for fathers, each exceeding the life expectancy for their era by a decade.

CONCLUSIONS:

Super-Seniors are cognitively and physically high functioning individuals who have evaded major age-related chronic diseases into old age, representing the approximately top 1% for healthspan. The familiality of long lifespan of the parents of Super-Seniors supports the hypothesis that heritable factors contribute to this desirable phenotype.

 

Longitudinal Analysis of Outpatient Physician Visits in the Oldest Old: Results of the AgeQualiDe Prospective Cohort Study.

Hajek A, Brettschneider C, van den Bussche H, Kaduszkiewicz H, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Stein J, Luck T, Bickel H, Mösch E, Heser K, Bleckwenn M, Scherer M, Riedel-Heller SG, Maier W, König HH.

J Nutr Health Aging. 2018;22(6):689-694. doi: 10.1007/s12603-018-0997-5.

PMID: 29806857

Abstract

OBJECTIVES:

The aim of this study was to identify determinants of outpatient health care utilization among the oldest old in Germany longitudinally.

DESIGN:

Multicenter prospective cohort "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe).

SETTING:

Individuals in very old age were recruited via GP offices at six study centers in Germany. The course of outpatient health care was observed over 10 months (two waves).

PARTICIPANTS:

Primary care patients aged 85 years and over (at baseline: n=861, with mean age of 89.0 years±2.9 years; 85-100 years).

MEASUREMENTS:

Self-reported numbers of outpatient visits to general practitioners (GP) and specialists in the past three months were used as dependent variables. Widely used scales were used to quantify explanatory variables (e.g., Geriatric Depression Scale, Instrumental Activities of Daily Living Scale, or Global Deterioration Scale).

RESULTS:

Fixed effects regressions showed that increases in GP visits were associated with increases in cognitive impairment, whereas they were not associated with changes in marital status, functional decline, increasing number of chronic conditions, increasing age, and changes in social network. Increases in specialist visits were not associated with changes in the explanatory variables.

CONCLUSION:

Our findings underline the importance of cognitive impairment for GP visits. Creating strategies to postpone cognitive decline might be beneficial for the health care system.

KEYWORDS:

Andersen’s behavioral model; Health care utilization ; longitudinal study; oldest old; outpatient

 

Associations of Body Mass Index and Waist Circumference with 3-Year All-Cause Mortality Among the Oldest Old: Evidence from a Chinese Community-Based Prospective Cohort Study.

Lv YB, Liu S, Yin ZX, Gao X, Kraus VB, Mao C, Yuan JQ, Zhang J, Luo JS, Chen HS, Zeng Y, Shi XM.

J Am Med Dir Assoc. 2018 May 25. pii: S1525-8610(18)30152-X. doi: 10.1016/j.jamda.2018.03.015. [Epub ahead of print]

PMID: 29807748

Abstract

OBJECTIVE:

Current international and national guidelines for body mass index (BMI) and waist circumference (WC) have been recommended to all adults. However, whether recommendations applied to the oldest old (aged 80+) is poorly known. The study objective was to investigate the relation of BMI and WC with 3-year all-cause mortality among the oldest old.

DESIGN, SETTING, AND PARTICIPANTS:

A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based prospective cohort study.

MEASUREMENTS:

BMI and WC were measured at baseline in 2011 and were used as continuous variables and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified Cox models with penalized splines and Cox models were constructed to explore the association.

RESULTS:

Greater BMI and WC were linearly associated with lower mortality risk in both genders. The mortality risk was the lowest in overweight or obese participants (BMI ≥ 24.0) and was lower in participants with abdominal obesity. Compared to the upper tertile, those in the middle and lower tertile of BMI had a higher risk of mortality for men [hazard ratio (HR): 1.23 (1.02-1.48) and 1.53 (1.28-1.82)] and for women [hr: 1.21 (1.03-1.41) and 1.35 (1.15-1.58)]; it was also found in participants in the middle and lower tertile of WC for men [hr: 1.21 (1.01-1.46) and 1.41 (1.18-1.69)] and for women [hr: 1.35 (1.15-1.58) and 1.55 (1.32-1.81)] (all the P values for trend <.001). These findings were robust in further sensitivity analyses or when using propensity score matching, in subgroup analyses, or in octogenarians, nonagenarians, and centenarians.

CONCLUSIONS:

In Chinese oldest old, both higher BMI and higher WC predict better survival in both genders. The finding suggests optimal BMI and WC may be sensitive to age, thus, the current recommendations for the oldest old may need to be revisited.

KEYWORDS:

Body mass index; mortality; oldest old; waist circumference

 

A cut-off of daily sedentary time and all-cause mortality in adults: a meta-regression analysis involving more than 1 million participants.

Ku PW, Steptoe A, Liao Y, Hsueh MC, Chen LJ.

BMC Med. 2018 May 25;16(1):74. doi: 10.1186/s12916-018-1062-2.

PMID: 29793552

https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-018-1062-2

Abstract

BACKGROUND:

The appropriate limit to the amount of daily sedentary time (ST) required to minimize mortality is uncertain. This meta-analysis aimed to quantify the dose-response association between daily ST and all-cause mortality and to explore the cut-off point above which health is impaired in adults aged 18-64 years old. We also examined whether there are differences between studies using self-report ST and those with device-based ST.

METHODS:

Prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were identified via MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar databases until January 2018. Dose-response relationships between daily ST and all-cause mortality were examined using random-effects meta-regression models.

RESULTS:

Based on the pooled data for more than 1 million participants from 19 studies, the results showed a log-linear dose-response association between daily ST and all-cause mortality. Overall, more time spent in sedentary behaviors is associated with increased mortality risks. However, the method of measuring ST moderated the association between daily ST and mortality risk (p < 0.05). The cut-off of daily ST in studies with self-report ST was 7 h/day in comparison with 9 h/day for those with device-based ST.

CONCLUSIONS:

Higher amounts of daily ST are log-linearly associated with increased risk of all-cause mortality in adults. On the basis of a limited number of studies using device-based measures, the findings suggest that it may be appropriate to encourage adults to engage in less sedentary behaviors, with fewer than 9 h a day being relevant for all-cause mortality.

KEYWORDS:

Cut-point; Inactivity; Recommendation; Review; Sedentary behavior; Sitting

 

Prostate-Specific Antigen-Based Screening for Prostate Cancer: Evidence Report and Systematic Review for the US Preventive Services Task Force.

Fenton JJ, Weyrich MS, Durbin S, Liu Y, Bang H, Melnikow J.

JAMA. 2018 May 8;319(18):1914-1931. doi: 10.1001/jama.2018.3712.

PMID: 29801018

https://jamanetwork.com/journals/jama/fullarticle/2680554

Abstract

IMPORTANCE:

Prostate cancer is the second leading cause of cancer death among US men.

OBJECTIVE:

To systematically review evidence on prostate-specific antigen (PSA)-based prostate cancer screening, treatments for localized prostate cancer, and prebiopsy risk calculators to inform the US Preventive Services Task Force.

DATA SOURCES:

Searches of PubMed, EMBASE, Web of Science, and Cochrane Registries and Databases from July 1, 2011, through July 15, 2017, with a surveillance search on February 1, 2018.

STUDY SELECTION:

English-language reports of randomized clinical trials (RCTs) of screening; cohort studies reporting harms; RCTs and cohort studies of active localized cancer treatments vs conservative approaches (eg, active surveillance, watchful waiting); external validations of prebiopsy risk calculators to identify aggressive cancers.

DATA EXTRACTION AND SYNTHESIS:

One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality.

MAIN OUTCOMES AND MEASURES:

Prostate cancer and all-cause mortality; false-positive screening results, biopsy complications, overdiagnosis; adverse effects of active treatments. Random-effects meta-analyses were conducted for treatment harms.

RESULTS:

Sixty-three studies in 104 publications were included (N = 1 904 950). Randomization to PSA screening was not associated with reduced risk of prostate cancer mortality in either a US trial with substantial control group contamination (n = 76 683) or a UK trial with low adherence to a single PSA screen (n = 408 825) but was associated with significantly reduced prostate cancer mortality in a European trial (n = 162 243; relative risk {RR}, 0.79 [95% CI, 0.69-0.91]; absolute risk reduction, 1.1 deaths per 10 000 person-years [95% CI, 0.5-1.8]). Of 61 604 men screened in the European trial, 17.8% received false-positive results. In 3 cohorts (n = 15 136), complications requiring hospitalization occurred in 0.5% to 1.6% of men undergoing biopsy after abnormal screening findings. Overdiagnosis was estimated to occur in 20.7% to 50.4% of screen-detected cancers. In an RCT of men with screen-detected prostate cancer (n = 1643), neither radical prostatectomy (hazard ratio


, 0.63 [95% CI, 0.21-1.93]) nor radiation therapy (HR, 0.51 [95% CI, 0.15-1.69]) were associated with significantly reduced prostate cancer mortality vs active monitoring, although each was associated with significantly lower risk of metastatic disease. Relative to conservative management, radical prostatectomy was associated with increased risk of urinary incontinence (pooled RR, 2.27 [95% CI, 1.82-2.84]; 3 trials; n = 1796) and erectile dysfunction (pooled RR, 1.82 [95% CI, 1.62-2.04]; 2 trials; n = 883). Relative to conservative management (8 cohort studies; n = 3066), radiation therapy was associated with increased risk of erectile dysfunction (pooled RR, 1.31 [95% CI, 1.20-1.42]).

CONCLUSIONS AND RELEVANCE:

PSA screening may reduce prostate cancer mortality risk but is associated with false-positive results, biopsy complications, and overdiagnosis. Compared with conservative approaches, active treatments for screen-detected prostate cancer have unclear effects on long-term survival but are associated with sexual and urinary difficulties.

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

Comment in

JAMA. 2018 May 8;319(18):1866-1868. doi: 10.1001/jama.2018.4914.

Prostate-Specific Antigen (PSA) Screening for Prostate Cancer: Revisiting the Evidence.

Carter HB1.

Author information

Comment on

PMID: 29800999 DOI: 10.1001/jama.2018.4914

https://jamanetwork.com/journals/jama/fullarticle/2680534

 

Effects of lifetime cumulative ginseng intake on cognitive function in late life.

Lho SK, Kim TH, Kwak KP, Kim K, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo JY, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han K, Hong JW, Han JW, Kim KW.

Alzheimers Res Ther. 2018 May 24;10(1):50. doi: 10.1186/s13195-018-0380-0.

PMID: 29793529

Abstract

BACKGROUND:

We investigated the effects of lifetime cumulative ginseng intake on cognitive function in a community-dwelling population-based prospective cohort of Korean elders.

METHODS:

Community-dwelling elders (N = 6422; mean age = 70.2 ± 6.9 years, education = 8.0 ± 5.3 years, female = 56.8%) from the Korean Longitudinal Study on Cognitive Aging and Dementia were included. Among them, 3918 participants (61.0%) completed the 2-year and 4-year follow-up evaluations. Subjects were categorized according to cumulative ginseng intake at baseline evaluation; no use group, low use (< 5 years) group, and high use (≥ 5 years) group. One-way analysis of covariance (ANCOVA) was conducted to compare the impact of cumulative ginseng intake on baseline Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet neuropsychological battery total score (CERAD total score) and Mini-Mental State Examination (MMSE) score among the three groups while adjusting for potential covariates. A repeated-measures ANCOVA was performed to investigate the impacts on the changes in CERAD total scores and MMSE scores during the 4 years of follow-up.

RESULTS:

The high use group showed higher CERAD total scores compared to the no use group after controlling for age, sex, education years, socioeconomic status, smoking, alcohol intake, presence of hypertension, stroke history, Geriatric Depression Scale, Cumulative Illness Rating Scale, and presence of the APOE e4 allele (F(2, 4762) = 3.978, p = 0.019). The changes of CERAD total score for 2 or 4 years of follow-up did not differ according to the use of ginseng.

CONCLUSIONS:

Cumulative ginseng use for longer than 5 years may be beneficial to cognitive function in late life.

KEYWORDS:

Aged; Cognition; Cohort studies; Ginseng; Longitudinal studies; Panax

 

Long-term nuts intake and metabolic syndrome: A 13-year longitudinal population-based study.

Hassannejad R, Mohammadifard N, Kazemi I, Mansourian M, Sadeghi M, Roohafza H, Sarrafzadegan N.

Clin Nutr. 2018 May 14. pii: S0261-5614(18)30178-X. doi: 10.1016/j.clnu.2018.05.006. [Epub ahead of print]

PMID: 29801674

Abstract

BACKGROUND & AIMS:

The ability of nuts to improve the conditions of the metabolic syndrome (MetS) is now well established. However, few longitudinal studies examined the impact of nuts on MetS and those that have been ongoing considered baseline measurement of nuts intake. The associations between nuts intake and the risk of MetS was longitudinally assessed in our study using repeated measurements of nuts intake.

METHODS:

The population-based longitudinal study was conducted on a sub-sample of the Isfahan Cohort Study (ICS), including 1387 adults, aged ≥ 35 years. A validated food frequency questionnaire was applied to obtain data on the nuts intake. International Diabetes Federation (IDF) criteria were used to define MetS. The longitudinal relation between the trend of nuts intake and the risk and severity of MetS was examined using the Logistic and Cumulative Logit regressions with considering mixed random effects.

RESULTS:

After adjustment for potential confounders, a statistically significant inverse association was found in severity of MetS (the number of positive criteria) in the second quartile of nuts compared with the lowest quartile (OR: 0.77, 95% PI: 0.63-0.96; P trend: 0.03). Nuts intake was inversely associated with MetS risk among participants in the second quartile compared with the lowest quartile (OR: 0.76, 95% PI: 0.59-0.96; P trend: 0.14).

CONCLUSIONS:

Nuts intake demonstrated a significant, inverse association with the risk and severity of MetS after a 13-year follow-up period in a cohort of the Iranian population.

KEYWORDS:

Isfahan cohort study; Metabolic syndrome; Nuts

 

The Effects of Extra Virgin Olive Oil on Alanine Aminotransferase, Aspartate Aminotransferase, and Ultrasonographic Indices of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Patients Undergoing Low Calorie Diet.

Shidfar F, Bahrololumi SS, Doaei S, Mohammadzadeh A, Gholamalizadeh M, Mohammadimanesh A.

Can J Gastroenterol Hepatol. 2018 Apr 17;2018:1053710. doi: 10.1155/2018/1053710. eCollection 2018.

PMID: 29850450

Abstract

BACKGROUND:

Coronary artery disease is the most common cause of death in the patients with nonalcoholic fatty liver disease (NAFLD). Studies have shown that there is a strong relation between the increase in the aminotransferase levels and fat accumulation in the liver with cardiovascular complications, independent of all aspects of the metabolic syndrome. This study aimed to examine the effect of virgin olive oil on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the severity of steatosis in the NAFLD patients undergoing a weight-loss diet.

METHODS:

This clinical trial was carried out on 50 patients with nonalcoholic fatty liver (mean age of 45.91 ± 9.61 years, mean BMI of 29.7 ± 0.58 Kg/m2) and the subjects were randomly assigned to the olive oil group (receiving the equivalent of 20% of their total daily energy requirement from olive oil) or the control group (with normal consumption of oil) for 12 weeks. All the patients received a hypocaloric diet during the study. At the beginning and the end of the study, the serum levels of ALT and AST and liver steatosis were measured.

FINDINGS:

A significant decrease in the level of ALT enzymes was observed in the control group at the end of the study (P = 0.004). In the olive oil group, both enzymes decreased compared to baseline measurements (P < 0.01). There were significant differences in the ALT and AST levels between the two groups (P < 0.02). The severity of liver steatosis did not change significantly during the study.

CONCLUSION:

The consumption of a low calorie diet enriched with olive oil, along with slight weight reduction, reinforces the desired effects of weight loss in improving the levels of the hepatic enzymes.

 

Potato Consumption Is not Associated with Higher Risk of Mortality: A Longitudinal Study among Southern Italian Older Adults.

Osella AR, Veronese N, Notarnicola M, Cisternino AM, Misciagna G, Guerra V, Nitti A, Campanella A, Caruso MG.

J Nutr Health Aging. 2018;22(6):726-730. doi: 10.1007/s12603-018-1018-4.

PMID: 29806862

Abstract

OBJECTIVE:

The consumption of potatoes is increasing worldwide, but few studies have assessed the association between potato consumption and mortality, particularly in Mediterranean countries. We therefore investigated whether potato consumption is associated with higher risk of death in a large cohort of people living in South Italy.

DESIGN:

Longitudinal.

SETTING:

Community-dwelling.

MEASUREMENTS:

2,442 participants coming from MICOL and NUTRIHEP studies aged more than 50 years at baseline were followed-up for 11 years. Dietary intake was assessed by means of a Food Frequency Questionnaire. Potato consumption was categorized in quintiles according to their daily consumption (< 3.95, 3.96-8.55, 8.56-15.67, 15.68-22.0, and > 22.0 g/day). Mortality was ascertained through validated cases of death. The association between potato consumption and mortality was assessed through Cox's regression models, adjusted for potential confounders, and reporting the data as hazard ratios (HRs) with 95% confidence intervals (CIs).

RESULTS:

The 2,442 eligible participants were prevalently males (54.6%) and aged a mean of 64.3±9.3 years. During the 11-year follow-up, 396 (=16.2%) participants died. After adjusting for 12 potential baseline confounders, and taking those with the lowest consumption of potatoes as the reference group, participants with the highest consumption of potatoes did not have an increased overall mortality risk (HR=0.75; 95%CI: 0.53-1.07). Modelling the potato consumption as continuous (i.e. as increase in 10 g/day) did not substantially change our findings (fully-adjusted HR=0.93; 95%CI: 0.84-1.02).

CONCLUSION:

Overall potato consumption was not associated with higher risk of death in older people living in a Mediterranean area. Future studies are warranted to elucidate the role of potato consumption on all-cause and cause-specific mortality.

KEYWORDS:

FFQ; Mediterranean diet; Potato; cohort study; mortality

 

What is the effect of diet and/or exercise interventions on behavioural compensation in non-exercise physical activity and related energy expenditure of free-living adults? A systematic review.

Silva AM, Júdice PB, Carraça EV, King N, Teixeira PJ, Sardinha LB.

Br J Nutr. 2018 Jun;119(12):1327-1345. doi: 10.1017/S000711451800096X.

PMID: 29845903

Abstract

Non-exercise physical activity (NEPA) and/or non-exercise activity thermogenesis (NEAT) reductions may occur from diet and/or exercise-induced negative energy balance interventions, resulting in less-than-expected weight loss. This systematic review describes the effects of prescribed diet and/or physical activity (PA)/exercise on NEPA and/or NEAT in adults. Studies were identified from PubMed, web-of-knowledge, Embase, SPORTDiscus, ERIC and PsycINFO searches up to 1 March 2017. Eligibility criteria included randomised controlled trials (RCT), randomised trials (RT) and non-randomised trials (NRT); objective measures of PA and energy expenditure; data on NEPA, NEAT and spontaneous PA; ≥10 healthy male/female aged>18 years; and ≥7 d length. The trial is registered at PROSPERO-2017-CRD42017052635. In all, thirty-six articles (RCT-10, RT-9, NRT-17) with a total of seventy intervention arms (diet, exercise, combined diet/exercise), with a total of 1561 participants, were included. Compensation was observed in twenty-six out of seventy intervention arms (fifteen studies out of thirty-six reporting declines in NEAT (eight), NEPA (four) or both (three)) representing 63, 27 and 23 % of diet-only, combined diet/exercise, and exercise-only intervention arms, respectively. Weight loss observed in participants who decreased NEAT was double the weight loss found in those who did not compensate, suggesting that the energy imbalance degree may lead to energy conservation. Although these findings do not support the hypothesis that prescribed diet and/or exercise results in decreased NEAT and NEPA in healthy adults, the underpowered trial design and the lack of state-of-the-art methods may limit these conclusions. Future studies should explore the impact of weight-loss magnitude, energetic restriction degree, exercise dose and participant characteristics on NEAT and/or NEPA.

KEYWORDS:

ACC accelerometer; DLW doubly labelled water; EE energy expenditure; EI energy intake; ExEE exercise energy expenditure; HR heart rate; NEAT non-exercise activity thermogenesis; NEPA non-exercise physical activity; NRT non-randomised trial; PA physical activity; PAEE physical activity energy expenditure; RCT randomised controlled trial; REE resting energy expenditure; RT randomised trials; SMR sleeping metabolic rate; TEE total energy expenditure; TEF thermic effect of food; Behavioural compensation; Energy balance; Energy expenditure; Free-living physical activity; Physical activity; Weight loss

 

Potato consumption and risk of pancreatic cancer in the HELGA cohort.

Åsli LA, Braaten T, Olsen A, Tjønneland A, Overvad K, Nilsson LM, Renström F, Lund E, Skeie G.

Br J Nutr. 2018 Jun;119(12):1408-1415. doi: 10.1017/S0007114518000788.

PMID: 29845900

Abstract

Potatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ's), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22, P for trend 0·030) when comparing the highest v. the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72, P for trend 0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84, P for trend 0·34). In addition, we explored the associations by spline regression, and the absence of dose-response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

KEYWORDS:

GI glycaemic index; HR hazard ratio; Cancer; Cohort studies; Epidemiology; Potatoes

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Leptin directly regulate intrinsic neuronal excitability in hypothalamic POMC neurons but not in AgRP neurons in food restricted mice.

Lee S, Lee J, Kang GM, Kim MS.

Neurosci Lett. 2018 May 29. pii: S0304-3940(18)30392-6. doi: 10.1016/j.neulet.2018.05.041. [Epub ahead of print]

PMID: 29857041

Abstract

Leptin plays a pivotal role in the central control of energy balance through leptin receptors expressed on specific hypothalamic nuclei. Leptin suppresses food intake and body weight and ameliorates hyperglycemia by acting on the AgRP and POMC neurons of the arcuate nucleus. Leptin action on POMC neurons are essential for control of body weight and blood glucose levels and are known to be mediated by JAK-STAT3 and PI3K signalling pathway thus increase POMC mRNA and intrinsic excitability. The effects of leptin on AgRP neurons are not as clear although it has been reported to hyperpolarize AgRP neurons through change of K+ conductance. Using cell-attached patch and whole cell patch configuration, we directly assessed neuronal response to leptin in GFP labelled AgRP or POMC neurons in mice after 18 hour of food deprivation. We found leptin has a direct effect on POMC neuron through increased intrinsic excitability and decreased inhibitory synaptic inputs. However, leptin does not have any effect on intrinsic excitability of AgRP neurons in fasted condition although food deprivation induced increase of firing frequency of AgRP neurons. In conclusion, leptin probably has a direct and acute effect on POMC neurons but not on AgRP neurons to control their excitability within feeding-regulatory neuronal circuitry.

KEYWORDS:

AgRP; Arcuate nucleus; Food deprivation; Leptin; Neuronal excitability; POMC]

 

Combined hormonal contraceptives use and bone mineral density changes in adolescent and young women in a prospective population-based Canada-wide observational study.

Brajic TS, Berger C, Schlammerl K, Macdonald H, Kalyan S, Hanley DA, Adachi JD, Kovacs CS, Prior JC; for the CaMos Research Group.

J Musculoskelet Neuronal Interact. 2018 Jun 1;18(2):227-236.

PMID: 29855445

Abstract

OBJECTIVES:

To assess combined hormonal contraceptives (CHC) use and adolescent women's peak areal bone mineral density (BMD) accrual.

METHODS:

We enrolled 527 randomly selected women across Canada (2004-6) divided by age into adolescents (16-19) and young adults (20-24) and by CHC use to ever (E-CHC)/never (N-CHC) users. At baseline and year 2 we measured height, weight, and BMD at lumbar spine (L1-4), femoral neck, and total hip sites. Interviewer-administered questionnaires addressed menarche age, cigarette and alcohol use, calcium/vitamin D intakes, physical activity and estrogen dose (≤30/>30 micrograms). Linear regression models examined associations of CHC use with 2-year BMD change adjusted for bone-related variables.

RESULTS:

Of 307 women with complete data, 229 (75%) used CHC. N-CHC adolescents gained significantly more unadjusted total hip BMD +0.012 g/cm2/2-y (95% C.I.: 0.001, 0.023) with similar trends at all sites. N-CHC adolescents tended to have greater adjusted femoral neck BMD gain: mean difference +0.009 g/cm2 (95% CI: -0.002; 0.021). In young women N-CHC, however, adjusted femoral neck BMD decreased significantly more -0.021 g/cm2 (95%CI: -0.006; -0.036) with similar trends at other sites. BMD changes were unrelated to estrogen dose and age at starting CHC.

CONCLUSIONS:

Adolescent CHC users in a random population demonstrated less hip region peak BMD accrual than non-users. This requires randomized control trial confirmation.

 

Associations of Dairy Intake with Arterial Stiffness in Brazilian Adults: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Ribeiro AG, Mill JG, Cade NV, Velasquez-Melendez G, Matos SMA, Molina MDCB.

Nutrients. 2018 May 31;10(6). pii: E701. doi: 10.3390/nu10060701.

PMID: 29857508 Free Article

http://www.mdpi.com/2072-6643/10/6/701

Abstract

Recent studies have suggested the possible effect of dairy product intake on cardiovascular risk markers, including arterial stiffness. Our aim was to investigate whether dairy food intake is associated with arterial stiffness, which we assessed by carotid-femoral pulse wave velocity (cfPWV) and pulse pressure (PP) in a cross-sectional analysis of baseline data (2008⁻2010; n = 12,892) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Dairy consumption was evaluated with a validated food-frequency questionnaire (FFQ) by computing servings per day for total and subgroups of dairy products. Dairy consumption was described in four categories (≤1 serving/day to >4 servings/day). Covariance analysis (ANCOVA) was used to compare cfPWV across increasing intake of dairy food, adjusting for confounding factors, including non-dairy food groups. The intake of total dairy was inversely associated with cfPWV and PP (-0.13 m/s and -1.3 mmHg, from the lowest and to the highest category of dairy intake). Low-fat dairy, fermented dairy and cheese showed an inverse relationship with cfPWV and PP. These findings suggest a beneficial effect of dairy consumption to reduce arterial stiffness. However, further evidence from longitudinal studies or long-term intervention is needed to support reduction of cfPWV and PP mediating the beneficial effects of dairy products on cardiovascular health.

KEYWORDS:

arterial stiffness; cardiovascular health; dairy; pulse wave velocity

 

Fatty acid quality and quantity of diet and risk of type 2 diabetes in adults: Tehran Lipid and Glucose Study.

Mirmiran P, Esfandyari S, Moghadam SK, Bahadoran Z, Azizi F.

J Diabetes Complications. 2018 May 7. pii: S1056-8727(18)30003-5. doi: 10.1016/j.jdiacomp.2018.05.003. [Epub ahead of print]

PMID: 29853261

Abstract

AIM:

Studies suggest that fatty acid intake may be an important determinant of type 2 diabetes mellitus (T2DM). This study aims to prospectively examine the association between fatty acid quantity and quality with risk of T2DM in adults.

METHODS:

In this community-based prospective sample, 2139 adults, free of T2DM, aged 20-70y-old were followed for a median of 5.8 y. Diet information was collected with the use of a validated questionnaire at baseline. Cox regression and 95% confidence intervals (CI), adjusted for age, diabetes risk score (DRS), and dietary intakes of energy, fiber and magnesium, were used to evaluate the association of fatty acid intakes with incident T2DM.

RESULTS:

During follow-up, we identified 143 incident T2D cases. In multivariable analyses, when extreme quintiles were compared, cholesterol (HR = 0.40; 95% CI: 0.20-0.82; P-trend, 0.02), monounsaturated fatty acids (HR = 0.30; 95% CI: 0.13-0.70; P-trend, 0.02), polyunsaturated fatty acids (HR = 0.45; 95% CI: 0.24-0.93 P-trend = 0.04) and ω-3 fatty acids (HR = 0.55; 95% CI: 0.31-0.88; P-trend = 0.02) were associated with T2DM. The ratio of ω-6 to total ω-3 intake was associated with a higher risk of T2D (HR = 1.65; 95% CI: 1.05-2.86; P-trend, 0.04). We also found positive associations between the ratios of total fat to ω-3 (HR = 1.65; 95% CI: 1.02-2.46; P-trend = 0.05).

CONCLUSIONS:

Our findings indicate that diets with high cholesterol, monounsaturated, polyunsaturated and ω-3 fatty acids are associated with a lower risk of T2DM. Also the ratios of ω-6/ω-3 and total fat/ω-3 were positively associated with T2DM.

KEYWORDS:

Diet; Fatty acids; Mono-unsaturated fat; Saturated fats; Type 2 diabetes; poly-unsaturated fat

 

Influence of aging in the modulation of epigenetic biomarkers of carcinogenesis after exposure to air pollution.

Fougère B, Landkocz Y, Lepers C, Martin PJ, Armand L, Grossin N, Verdin A, Boulanger E, Gosset P, Sichel F, Shirali P, Billet S.

Exp Gerontol. 2018 May 31. pii: S0531-5565(18)30128-1. doi: 10.1016/j.exger.2018.05.018. [Epub ahead of print]

PMID: 29860068

Abstract

BACKGROUND:

Classified as carcinogenic to humans by the IARC in 2013, fine air particulate matter (PM2.5) can be inhaled and retained into the lung or reach the systemic circulation. This can cause or exacerbate numerous pathologies to which the elderly are often more sensitive.

METHODS:

In order to estimate the influence of age on the development of early cellular epigenetic alterations involved in carcinogenesis, peripheral blood mononuclear cells sampled from 90 patients from three age classes (25-30, 50-55 and 75-80 years old) were ex vivo exposed to urban PM2.5.

RESULTS:

Particles exposure led to variations in telomerase activity and telomeres length in all age groups without any influence of age. Conversely, P16INK4A gene expression increased significantly with age after exposure to PM2.5. Age could enhance [O(6)-methylguanine-DNA methyltransferase (MGMT)] gene expression after exposure to particles, by decreasing the level of promoter methylation in the oldest people.

CONCLUSION:

Hence, our results demonstrated several tendencies in cells modification depending on age, even if all epigenetic assays were carried out after a limited exposure time allowing only one or two cell cycles. Since lung cancer symptoms appear only at an advanced stage, our results underline the needs for further investigation on the studied biomarkers for early diagnosis of carcinogenesis to improve survival.

KEYWORDS:

Aging; Biomarkers; Epigenotoxicity; PBMC; PM(2.5)

 

[Thermal and Lighting Housing Environments and Circadian Blood Pressure Variability: Findings from the HEIJO-KYO Cohort].

Obayashi K, Saeki K.

Nihon Eiseigaku Zasshi. 2018;73(2):138-142. doi: 10.1265/jjh.73.138. Japanese.

PMID: 29848864 Free Article

Abstract

The purpose of this short review is to describe the influence of housing environment temperature and lighting on circadian blood pressure (BP) variability using data from the HEIJO-KYO cohort, a community-based cohort study launched in 2010. Increased excess mortality from cardiovascular disease in winter is a worldwide problem. Previous studies showed higher conventional BP and higher daytime ambulatory BP in winter; however, the relationship between indoor cold exposure and circadian BP variability remained unknown. In our cohort, we found a significant inverse relationship between indoor temperature and morning BP surge, independent of potential confounding factors. In addition, we found the tertile group with the lowest daytime indoor temperatures showed significantly higher urinary sodium excretion than the tertile group with the highest daytime indoor temperatures. Higher sodium intake caused by indoor cold exposure may partly explain the higher BP in winter. Physiologically, light exposure is the most important environmental cue for the circadian timing system and melatonin secretion. In our cohort, we observed that an increase in nighttime short-wave length light exposure and a decrease in daytime light exposure were significantly associated with lower melatonin secretion. Furthermore, lower melatonin levels were significantly related to higher nighttime BPs and parameters of atherosclerosis, which are predictors of cardiovascular disease incidence. Further longitudinal studies of the influence of housing environment temperature and lighting on cardiovascular disease incidence are required.

KEYWORDS:

temperature; blood pressure; circadian rhythms; light; melatonin

 

Does cigarette smoking increase traffic accident death during 20 years follow-up in Japan?: The Ibaraki Prefectural Health Study.

Igarashi A, Aida J, Sairenchi T, Tsuboya T, Sugiyama K, Koyama S, Matsuyama Y, Sato Y, Osaka K, Ota H.

J Epidemiol. 2018 May 31. doi: 10.2188/jea.JE20170330. [Epub ahead of print]

PMID: 29848905 Free Article

Abstract

BACKGROUND:

Annually, more than 1.2 million deaths due to road traffic accidents occur worldwide. Although previous studies have examined the association between cigarette smoking and injury death, the mortality outcome often included non-traffic accident-related deaths. This study aimed to examine the association between cigarette smoking and traffic accident death.

METHODS:

We conducted a prospective cohort study using data from the Ibaraki Prefectural Health Study conducted between 1993 and 2013. The cohort included 97,078 adults (33,138 men and 63,940 women) living in Ibaraki Prefecture, who were aged 40-79 years at an annual health checkup in 1993. We divided participants into four smoking status groups: non-smokers, ex-smokers and current smokers who smoked <20 and ≥20 cigarettes per day. Hazard ratios (HRs) of traffic accident death were calculated using a Cox proportional hazards model.

RESULTS:

During 20 years of follow-up, average person-year of follow-up were 16.8 and 18.2 in men and women, respectively. Among men, after adjusting for age and alcohol intake, compared to non-smokers, HRs for traffic accident death among current smokers of <20 cigarettes/day and ≥20 cigarettes/day were 1.32 (95% confidence interval (CI), 0.79-2.20) and 1.54 (95% CI, 0.99-2.39), respectively. In contrast, among women, we found no association between smoking status and traffic accident deaths.

CONCLUSION:

In this prospective cohort study, we found a positive association, though marginally significant, between smoking and traffic accident death among men in Japan. Among women, because smaller number of death among smokers, adequate estimation could not be obtained.

KEYWORDS:

cigarette; cohort study; smoking; traffic accident

 

[Association between feelings of happiness among community-dwelling, independent, elderly individuals in an Okinawan farm village and survival three years later].

Kodama S, Kurimori S, Hoshi T.

Nihon Koshu Eisei Zasshi. 2018;65(5):199-209. doi: 10.11236/jph.65.5_199. Japanese.

PMID: 29848914 Free Article

Abstract

Objectives As an indicator of subjective wellbeing, feelings of happiness assessed based on simple items have not been fully elucidated in terms of its relation to survival during old age. The purpose of this study was to examine whether the predictive validity of feelings of happiness assessed using a 4-item measure is high as an indicator of assessing survival three years later, using a variety of factors as adjustment variables among independent, elderly individuals living in a farm village in Okinawa, wherein a spirit of mutual help is prevalent among the residents.Methods From a longitudinal study conducted in 2012, a total of 1,471 respondents (638 men, 833 women), excluding participants who needed long-term care and non-respondents of their feelings of happiness, completed a detailed questionnaire. A 4-item measure of feelings of happiness and other indicators of subjective wellbeing, including a 5-item measure of cooked food consumption, were considered as ordinal scales. From the results of the principal component (PC) analysis, we named the first PC "diet variety," of which cooked food was less consumed. The Cox proportional hazard model was used for 734 subjects' data, excluding missing values, to examine comprehensive associations among feelings of happiness, survival times, and health indicators in a multivariate model that adjusted for age, sex, and body mass index, among others. A correlation analysis between survival after three years was performed to select indicators used simultaneously in the analysis. Kaplan-Meier analysis was also conducted to examine the cumulative survival rate over three years.Results A total of 1,387 participants (94.3%) survived during the three-year follow-up. The survival rate was significantly higher in those who indicated "very happy" items (95.9%) than in those who indicated "unhappy" items (86.4%). Meanwhile, the mortality rate was significantly higher in those who indicated "unhappy" items (13.6%) than in those who indicated "very happy" items (4.1%). Within the multivariate model, the hazard ratio (HR) for mortality three years later was significantly reduced in those with feelings of happiness (HR=0.56, 95% confidence interval [CI]: 0.32-0.99), in those who did not experiences falls and fractures (HR=0.26, 95% CI:0.11-0.62), and in those who were non-smokers (HR=0.44, 95% CI:0.25-0.77). The cumulative survival rate in those who experienced good feelings of happiness was significantly higher than in the others.Conclusion The predictive validity of feelings of happiness assessed by a 4-item measure might be high as an indicator to assess survival three years later among independent, elderly individuals living in a farm village in Okinawa.

KEYWORDS: Cox proportional hazard model; feelings of happiness; independent elderly; subjective wellbeing; survival

 

Effect of Soy Isoflavone on Hot Flushes, Endometrial Thickness, and Breast Clinical as well as Sonographic Features.

Vahid Dastjerdi M, Eslami B, Alsadat Sharifi M, Moini A, Bayani L, Mohammad Khani H, Alipour S.

Iran J Public Health. 2018 Mar;47(3):382-389.

PMID: 29845026 Free PMC Article

Abstract

BACKGROUND:

Phytoestrogens treatment to relieve hot flushes in menopausal women was considered recently. However, the actual effectiveness and safety are not clear.

METHODS:

Randomized clinical trial (IRCT#20100706004329N5) was performed in 204 patients who complained of hot flushes in Arash Women's Hospital, Tehran, Iran from 2013-2015. The first group received 50 mg isoflavone (group A) once daily and the second group received placebo (group B) in the same regimen. Patients were evaluated for breast examination (BE) and breast sonography (BS) as well as vaginal sonography at initial presentation and at 6th and 12th week follow-ups. Patients were educated to record frequency and severity of hot flushes.

RESULTS:

Group A experienced less hot flushes attack (6 vs 9 patients with 5< attacks in 6 wk (P= 0.05), 7 Vs 13 patients with 5< in 12 wk (P=0.01)) which was also less severe (8 vs 12 patients with severe symptoms in 6 wk (0.04) and 3 Vs 10 patients with severe symptoms in 12 wk (0.001). Isoflavone had no effect on neither breast density nor nodularity (in 6 wk, P=0.50 and 0.80, respectively and in 12 wk, P=0.32 and 0.43) and neither breast tenderness nor nipple discharge (in 6 wk, P=0.40 and 0.34 respectively and in 12 wk, P= 0.31 and 0.26). There were no significant differences in endometrial thickness in 6 and 12wk.

CONCLUSION:

Effects of isoflavone on frequency and severity of hot flushes in perimenopausal women is observed. Some clinical and ultrasonographic benign non-significant changes of the breast and endometrium are noted after isoflavone intake.

KEYWORDS:

Breast tissue; Endometrial thickness; Hot flushes; Isoflavone

 

Association of Daily Intellectual Activities With Lower Risk of Incident Dementia Among Older Chinese Adults.

Lee ATC, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW.

JAMA Psychiatry. 2018 May 30. doi: 10.1001/jamapsychiatry.2018.0657. [Epub ahead of print]

PMID: 29847678

Abstract

IMPORTANCE:

Associations between late-life participation in intellectual activities and decreased odds of developing dementia have been reported. However, reverse causality and confounding effects due to other health behaviors or problems have not been adequately addressed.

OBJECTIVE:

To examine whether late-life participation in intellectual activities is associated with a lower risk of incident dementia years later, independent of other lifestyle and health-related factors.

DESIGN, SETTING, AND PARTICIPANTS:

A longitudinal observational study was conducted at all Elderly Health Centres of the Department of Health of the Government of Hong Kong among 15 582 community-living Chinese individuals age 65 years or older at baseline who were free of dementia, with baseline evaluations performed January 1 to June 30, 2005, and follow-up assessments performed from January 1, 2006, to December 31, 2012. Statistical analysis was performed from January 1, 2015, to December 31, 2016.

MAIN OUTCOMES AND MEASURES:

The main outcome was incident dementia as diagnosed by geriatric psychiatrists in accordance with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, or a Clinical Dementia Rating of 1 to 3. At baseline and follow-up interviews, self-reported information on participation in intellectual activities within 1 month before assessment was collected. Examples of intellectual activities, which were described by a local validated classification system, were reading books, newspapers, or magazines; playing board games, Mahjong, or card games; and betting on horse racing. Other important variables including demographics (age, sex, and educational level), physical and psychiatric comorbidities (cardiovascular risks, depression, visual and hearing impairments, and poor mobility), and lifestyle factors (physical exercise, adequate fruit and vegetable intake, smoking, and recreational and social activities) were also assessed.

RESULTS:

Of the 15 582 individuals in the study, 9950 (63.9%) were women, and the median age at baseline was 74 years (interquartile range, 71-77 years). A total of 1349 individuals (8.7%) developed dementia during a median follow-up period of 5.0 years. Multivariable logistic regression analysis showed that the estimated odds ratio for incident dementia was 0.71 (95% CI, 0.60-0.84; P < .001) for those with intellectual activities at baseline, after excluding those who developed dementia within 3 years after baseline and adjusting for health behaviors, physical and psychiatric comorbidities, and sociodemographic factors.

 

CONCLUSIONS AND RELEVANCE:

Active participation in intellectual activities, even in late life, might help delay or prevent dementia in older adults.

 

Intake of Different Dietary Proteins and Risk of Heart Failure in Men: The Kuopio Ischaemic Heart Disease Risk Factor Study.

Virtanen HEK, Voutilainen S, Koskinen TT, Mursu J, Tuomainen TP, Virtanen JK.

Circ Heart Fail. 2018 Jun;11(6):e004531. doi: 10.1161/CIRCHEARTFAILURE.117.004531.

PMID: 29844244

Abstract

BACKGROUND:

Animal and plant protein intakes have indicated opposite associations with cardiovascular mortality risk. Whether dietary proteins are associated with risk of heart failure (HF) is unclear. Thus, we examined the associations of proteins from different food sources with risk of HF.

METHODS AND RESULTS:

The study included 2441 men aged 42 to 60 years at the baseline examinations in 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Protein intakes at baseline were assessed with 4-day dietary records. Data on incident HF cases were obtained from national registers. HF risk according to protein intake was estimated by Cox proportional hazard ratios. During the mean follow-up of 22.2 years, 334 incident HF cases occurred. Higher intake of total protein indicated a trend toward increased risk of HF (multivariable-adjusted hazard ratio in the highest versus lowest quartile=1.33; 95% confidence interval: 0.95-1.85; P-trend=0.05). The associations between specific types and sources of protein with incident HF were consistent with this overall finding although not all associations reached statistical significance. For example, the hazard ratio in the highest versus lowest quartile was 1.43 (95% confidence interval: 1.00-2.03; P-trend=0.07) for total animal protein and 1.17 (95% confidence interval: 0.72-1.91; P-trend=0.35) for total plant protein.

CONCLUSIONS:

In middle-aged men, higher protein intake was marginally associated with increased risk of HF.

CLINICAL TRIAL REGISTRATION:

URL: https://www.clinicaltrials.gov. Unique identifier: NCT03221127.

KEYWORDS:

calcium; dietary proteins; heart failure; men; prospective studies

 

Many breast cancer patients can skip chemo, big U.S. study finds

Majority of patients in intermediate risk zone do just as well with surgery followed by hormone therapy

The Associated Press · Posted: Jun 03, 2018

http://www.cbc.ca/news/health/breast-cancer-chemotherapy-1.4689700

 

Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts.

Stamatakis E, Kelly P, Strain T, Murtagh EM, Ding D, Murphy MH.

Br J Sports Med. 2018 Jun;52(12):761-768. doi: 10.1136/bjsports-2017-098677.

PMID: 29858463

Abstract

BACKGROUND/OBJECTIVES:

Walking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and body mass index (BMI).

METHODS:

Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer and cardiovascular disease (CVD) mortality.

RESULTS:

50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality.

CONCLUSION:

Walking benefits health. Assuming causality, these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.

KEYWORDS:

cohort study; epidemiology; physical activity; public health; walking

 

Genomic Approach to Understand the Association of DNA Repair with Longevity and Healthy Aging Using Genomic Databases of Oldest-Old Population.

Kim YJ, Kim HS, Seo YR.

Oxid Med Cell Longev. 2018 May 3;2018:2984730. doi: 10.1155/2018/2984730. eCollection 2018. Review.

PMID: 29854078

Abstract

Aged population is increasing worldwide due to the aging process that is inevitable. Accordingly, longevity and healthy aging have been spotlighted to promote social contribution of aged population. Many studies in the past few decades have reported the process of aging and longevity, emphasizing the importance of maintaining genomic stability in exceptionally long-lived population. Underlying reason of longevity remains unclear due to its complexity involving multiple factors. With advances in sequencing technology and human genome-associated approaches, studies based on population-based genomic studies are increasing. In this review, we summarize recent longevity and healthy aging studies of human population focusing on DNA repair as a major factor in maintaining genome integrity. To keep pace with recent growth in genomic research, aging- and longevity-associated genomic databases are also briefly introduced. To suggest novel approaches to investigate longevity-associated genetic variants related to DNA repair using genomic databases, gene set analysis was conducted, focusing on DNA repair- and longevity-associated genes. Their biological networks were additionally analyzed to grasp major factors containing genetic variants of human longevity and healthy aging in DNA repair mechanisms. In summary, this review emphasizes DNA repair activity in human longevity and suggests approach to conduct DNA repair-associated genomic study on human healthy aging.

 

SIRT1, miR-132 and miR-212 link human longevity to Alzheimer's Disease.

Hadar A, Milanesi E, Walczak M, Puzianowska-Kuźnicka M, Kuźnicki J, Squassina A, Niola P, Chillotti C, Attems J, Gozes I, Gurwitz D.

Sci Rep. 2018 May 31;8(1):8465. doi: 10.1038/s41598-018-26547-6.

PMID: 29855513

Abstract

Alzheimer's Disease (AD) is the most common cause of dementia in the elderly. Centenarians - reaching the age of >100 years while maintaining good cognitive skills - seemingly have unique biological features allowing healthy aging and protection from dementia. Here, we studied the expression of SIRT1 along with miR-132 and miR-212, two microRNAs known to regulate SIRT1, in lymphoblastoid cell lines (LCLs) from 45 healthy donors aged 21 to 105 years and 24 AD patients, and in postmortem olfactory bulb and hippocampus tissues from 14 AD patients and 20 age-matched non-demented individuals. We observed 4.0-fold (P = 0.001) lower expression of SIRT1, and correspondingly higher expression of miR-132 (1.7-fold; P = 0.014) and miR-212 (2.1-fold; P = 0.036), in LCLs from AD patients compared with age-matched healthy controls. Additionally, SIRT1 expression was 2.2-fold (P = 0.001) higher in centenarian LCLs compared with LCLs from individuals aged 56-82 years; while centenarian LCLs miR-132 and miR-212 indicated 7.6-fold and 4.1-fold lower expression, respectively. Correlations of SIRT1, miR-132 and miR-212 expression with cognitive scores were observed for AD patient-derived LCLs and postmortem AD olfactory bulb and hippocampus tissues, suggesting that higher SIRT1 expression, possibly mediated by lower miR-132 and miR-212, may protect aged individuals from dementia and is reflected in their peripheral tissues.

 

Supplemental Vitamins and Minerals for CVD Prevention and Treatment.

Jenkins DJA, Spence JD, Giovannucci EL, Kim YI, Josse R, Vieth R, Blanco Mejia S, Viguiliouk E, Nishi S, Sahye-Pudaruth S, Paquette M, Patel D, Mitchell S, Kavanagh M, Tsirakis T, Bachiri L, Maran A, Umatheva N, McKay T, Trinidad G, Bernstein D, Chowdhury A, Correa-Betanzo J, Del Principe G, Hajizadeh A, Jayaraman R, Jenkins A, Jenkins W, Kalaichandran R, Kirupaharan G, Manisekaran P, Qutta T, Shahid R, Silver A, Villegas C, White J, Kendall CWC, Pichika SC, Sievenpiper JL.

J Am Coll Cardiol. 2018 Jun 5;71(22):2570-2584. doi: 10.1016/j.jacc.2018.04.020. Review.

PMID: 29852980

Abstract

The authors identified individual randomized controlled trials from previous meta-analyses and additional searches, and then performed meta-analyses on cardiovascular disease outcomes and all-cause mortality. The authors assessed publications from 2012, both before and including the U.S. Preventive Service Task Force review. Their systematic reviews and meta-analyses showed generally moderate- or low-quality evidence for preventive benefits (folic acid for total cardiovascular disease, folic acid and B-vitamins for stroke), no effect (multivitamins, vitamins C, D, β-carotene, calcium, and selenium), or increased risk (antioxidant mixtures and niacin [with a statin] for all-cause mortality). Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks.

KEYWORDS:

all-cause mortality; meta-analysis; supplements

 

Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke: EPIC-CVD case-cohort study.

Ricci C, Wood A, Muller D, Gunter MJ, Agudo A, Boeing H, van der Schouw YT, Warnakula S, Saieva C, Spijkerman A, Sluijs I, Tjønneland A, Kyrø C, Weiderpass E, Kühn T, Kaaks R, Sánchez MJ, Panico S, Agnoli C, Palli D, Tumino R, Engström G, Melander O, Bonnet F, Boer JMA, Key TJ, Travis RC, Overvad K, Verschuren WMM, Quirós JR, Trichopoulou A, Papatesta EM, Peppa E, Iribas CM, Gavrila D, Forslund AS, Jansson JH, Matullo G, Arriola L, Freisling H, Lassale C, Tzoulaki I, Sharp SJ, Forouhi NG, Langenberg C, Saracci R, Sweeting M, Brennan P, Butterworth AS, Riboli E, Wareham NJ, Danesh J, Ferrari P.

BMJ. 2018 May 29;361:k934. doi: 10.1136/bmj.k934.

PMID: 29844013 Free Article

Abstract

OBJECTIVE:

To investigate the association between alcohol consumption (at baseline and over lifetime) and non-fatal and fatal coronary heart disease (CHD) and stroke.

DESIGN:

Multicentre case-cohort study.

SETTING:

A study of cardiovascular disease (CVD) determinants within the European Prospective Investigation into Cancer and nutrition cohort (EPIC-CVD) from eight European countries.

PARTICIPANTS:

32 549 participants without baseline CVD, comprised of incident CVD cases and a subcohort for comparison.

MAIN OUTCOME MEASURES:

Non-fatal and fatal CHD and stroke (including ischaemic and haemorrhagic stroke).

RESULTS:

There were 9307 non-fatal CHD events, 1699 fatal CHD, 5855 non-fatal stroke, and 733 fatal stroke. Baseline alcohol intake was inversely associated with non-fatal CHD, with a hazard ratio of 0.94 (95% confidence interval 0.92 to 0.96) per 12 g/day higher intake. There was a J shaped association between baseline alcohol intake and risk of fatal CHD. The hazard ratios were 0.83 (0.70 to 0.98), 0.65 (0.53 to 0.81), and 0.82 (0.65 to 1.03) for categories 5.0-14.9 g/day, 15.0-29.9 g/day, and 30.0-59.9 g/day of total alcohol intake, respectively, compared with 0.1-4.9 g/day. In contrast, hazard ratios for non-fatal and fatal stroke risk were 1.04 (1.02 to 1.07), and 1.05 (0.98 to 1.13) per 12 g/day increase in baseline alcohol intake, respectively, including broadly similar findings for ischaemic and haemorrhagic stroke. Associations with cardiovascular outcomes were broadly similar with average lifetime alcohol consumption as for baseline alcohol intake, and across the eight countries studied. There was no strong evidence for interactions of alcohol consumption with smoking status on the risk of CVD events.

CONCLUSIONS:

Alcohol intake was inversely associated with non-fatal CHD risk but positively associated with the risk of different stroke subtypes. This highlights the opposing associations of alcohol intake with different CVD types and strengthens the evidence for policies to reduce alcohol consumption.

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SECOND OPINION

Baking literally burns off sugar calories

Sugars are reactive when heated, which could reduce calories in baked goods, according to UBC research

Showwei Chu · CBC News · Posted: Jun 05, 2018

http://www.cbc.ca/news/health/second-opinion-baking-calories-1.4690996

 

Effects of Panax ginseng on Obesity in Animal Models: A Systematic Review and Meta-Analysis.

Park HS, Cho JH, Kim KW, Chung WS, Song MY.

Evid Based Complement Alternat Med. 2018 May 15;2018:2719794. doi: 10.1155/2018/2719794. eCollection 2018. Review.

PMID: 29861768

http://www.mdpi.com/2072-6643/10/6/680/htm

Abstract

OBJECTIVE:

To determine the antiobesity effects of Panax ginseng in animals.

METHODS:

We conducted a systematic search for all controlled trials (up to March 2017) that assessed the antiobesity effects of P. ginseng in animal obesity models in the PubMed, EMBASE, Cochrane library, Web of Science, and Scopus databases. The primary outcome was final body weight measured at the longest follow-up time after administration of the intervention. The secondary outcome was the lipid profile. We assessed methodological quality using the SYRCLE risk of bias tool, and RevMan 5.3 was used to perform a meta-analysis. Finally, a subgroup analysis of parameters including intervention duration, animal models, and type of ginseng was performed.

RESULT:

We identified 16 studies that met the inclusion criteria. Data from the meta-analysis indicated that the intervention group had a significantly lower body weight than the control group (SMD: -1.50, 95% CI: -1.90 to -1.11, χ2: 78.14, P < 0.0001, I2 = 58%). Final body weight was lower in an animal obesity model induced by high-fat diet than in genetic models. Also the intervention group had a significantly higher serum HDL level and lower serum LDL, TG, and TC level than the control group.

CONCLUSION:

Our meta-analysis indicated that oral administration of P. ginseng significantly inhibits weight gain and improves serum lipid profiles in animal obesity models. However, causes of obesity and type of ginseng may affect treatment effects.

 

Individual and combined impact of lifestyle factors on atrial fibrillation in apparently healthy men and women: The EPIC-Norfolk prospective population study.

Di Benedetto L, Michels G, Luben R, Khaw KT, Pfister R.

Eur J Prev Cardiol. 2018 Jan 1:2047487318782379. doi: 10.1177/2047487318782379. [Epub ahead of print]

PMID: 29863403

Abstract

Background Lifestyle factors are important targets for prevention. The cumulative impact of healthy lifestyle on atrial fibrillation in the population has not been quantified. Design Prospective population-based cohort study. Methods Four lifestyle factors (normal weight, currently not smoking, no or moderate alcohol intake, and physically not inactive) were assessed in apparently healthy 21,499 men and women aged 39-79 years participating in the EPIC study in Norfolk, UK. The age and sex-adjusted hazard (95% confidence interval) of hospital admission with a diagnosis of atrial fibrillation during an average follow-up of 17.1 years was examined for each factor separately and for a health score comprising factors with significant impact. Results Normal weight, currently not smoking and low alcohol intake were associated with a significantly lower risk of atrial fibrillation, whereas not being physically inactive showed no significant association. We used a score of one point each for not smoking, low alcohol intake and body mass index 25 to 27.5 kg/m2, and two points for body mass index < 25 kg/m2. Compared with men and women with four health points, hazard ratios of atrial fibrillation were 1.25 (1.11-1.41), 1.56 (1.39-1.75), 1.83 (1.56-2.16) and 2.82 (1.85-4.29) for participants with three, two, one and no health points, respectively ( p < 0.0001 for trend). Results were consistent by sex, age, education level, social class and after excluding participants with hypertension and diabetes. Conclusion Three lifestyle factors combined predict an almost 2.8-fold difference in the risk of atrial fibrillation in men and women.

KEYWORDS:

 

Vitamin C: should we supplement?

Spoelstra-de Man AME, Elbers PWG, Oudemans-Van Straaten HM.

Curr Opin Crit Care. 2018 Jun 1. doi: 10.1097/MCC.0000000000000510. [Epub ahead of print]

PMID: 29864039

Abstract

PURPOSE OF REVIEW:

Hypovitaminosis C and vitamin C deficiency are very common in critically ill patients due to increased needs and decreased intake. Because vitamin C has pleiotropic functions, deficiency can aggravate the severity of illness and hamper recovery.

RECENT FINDINGS:

Vitamin C is a key circulating antioxidant with anti-inflammatory and immune-supporting effects, and a cofactor for important mono and dioxygenase enzymes. An increasing number of preclinical studies in trauma, ischemia/reperfusion, and sepsis models show that vitamin C administered at pharmacological doses attenuates oxidative stress and inflammation, and restores endothelial and organ function. Older studies showed less organ dysfunction when vitamin C was administered in repletion dose (2-3 g intravenous vitamin C/day). Recent small controlled studies using pharmacological doses (6-16 g/day) suggest that vitamin C reduces vasopressor support and organ dysfunction, and may even decrease mortality.

SUMMARY:

A short course of intravenous vitamin C in pharmacological dose seems a promising, well tolerated, and cheap adjuvant therapy to modulate the overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia. Large randomized controlled trials are necessary to provide more evidence before wide-scale implementation can be recommended.

 

Prescribed hypocaloric nutrition support for critically-ill adults.

Perman MI, Ciapponi A, Franco JV, Loudet C, Crivelli A, Garrote V, Perman G.

Cochrane Database Syst Rev. 2018 Jun 4;6:CD007867. doi: 10.1002/14651858.CD007867.pub2. [Epub ahead of print] Review.

PMID: 29864793

Abstract

BACKGROUND:

There are controversies about the amount of calories and the type of nutritional support that should be given to critically-ill people. Several authors advocate the potential benefits of hypocaloric nutrition support, but the evidence is inconclusive.

OBJECTIVES:

To assess the effects of prescribed hypocaloric nutrition support in comparison with standard nutrition support for critically-ill adults SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Cochrane Library), MEDLINE, Embase and LILACS (from inception to 20 June 2017) with a specific strategy for each database. We also assessed three websites, conference proceedings and reference lists, and contacted leaders in the field and the pharmaceutical industry for undetected/unpublished studies. There was no restriction by date, language or publication status.

SELECTION CRITERIA:

We included randomized and quasi-randomized controlled trials comparing hypocaloric nutrition support to normo- or hypercaloric nutrition support or no nutrition support (e.g. fasting) in adults hospitalized in intensive care units (ICUs).

DATA COLLECTION AND ANALYSIS:

We used standard methodological procedures expected by Cochrane. We meta-analysed data for comparisons in which clinical heterogeneity was low. We conducted prespecified subgroup and sensitivity analyses, and post hoc analyses, including meta-regression. Our primary outcomes were: mortality (death occurred during the ICU and hospital stay, or 28- to 30-day all-cause mortality); length of stay (days stayed in the ICU and in the hospital); and Infectious complications. Secondary outcomes included: length of mechanical ventilation. We assessed the quality of evidence with GRADE.

MAIN RESULTS:

We identified 15 trials, with a total of 3129 ICU participants from university-associated hospitals in the USA, Colombia, Saudi Arabia, Canada, Greece, Germany and Iran. There are two ongoing studies. Participants suffered from medical and surgical conditions, with a variety of inclusion criteria. Four studies used parenteral nutrition and nine studies used only enteral nutrition; it was unclear whether the remaining two used parenteral nutrition. Most of them could not achieve the proposed caloric targets, resulting in small differences in the administered calories between intervention and control groups. Most studies were funded by the US government or non-governmental associations, but three studies received funding from industry. Five studies did not specify their funding sources.The included studies suffered from important clinical and statistical heterogeneity. This heterogeneity did not allow us to report pooled estimates of the primary and secondary outcomes, so we have described them narratively.When comparing hypocaloric nutrition support with a control nutrition support, for hospital mortality (9 studies, 1775 participants), the risk ratios ranged from 0.23 to 5.54; for ICU mortality (4 studies, 1291 participants) the risk ratios ranged from 0.81 to 5.54, and for mortality at 30 days (7 studies, 2611 participants) the risk ratios ranged from 0.79 to 3.00. Most of these estimates included the null value. The quality of the evidence was very low due to unclear or high risk of bias, inconsistency and imprecision.Participants who received hypocaloric nutrition support compared to control nutrition support had a range of mean hospital lengths of stay of 15.70 days lower to 10.70 days higher (10 studies, 1677 participants), a range of mean ICU lengths of stay 11.00 days lower to 5.40 days higher (11 studies, 2942 participants) and a range of mean lengths of mechanical ventilation of 13.20 days lower to 8.36 days higher (12 studies, 3000 participants). The quality of the evidence for this outcome was very low due to unclear or high risk of bias in most studies, inconsistency and imprecision.The risk ratios for infectious complications (10 studies, 2804 participants) of each individual study ranged from 0.54 to 2.54. The quality of the evidence for this outcome was very low due to unclear or high risk of bias, inconsistency and imprecisionWe were not able to explain the causes of the observed heterogeneity using subgroup and sensitivity analyses or meta-regression.

AUTHORS' CONCLUSIONS:

The included studies had substantial clinical heterogeneity. We found very low-quality evidence about the effects of prescribed hypocaloric nutrition support on mortality in hospital, in the ICU and at 30 days, as well as in length of hospital and ICU stay, infectious complications and the length of mechanical ventilation. For these outcomes there is uncertainty about the effects of prescribed hypocaloric nutrition, since the range of estimates includes both appreciable benefits and harms.Given these limitations, results must be interpreted with caution in the clinical field, considering the unclear balance of the risks and harms of this intervention. Future research addressing the clinical heterogeneity of participants and interventions, study limitations and sample size could clarify the effects of this intervention.

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Adiposity and risks of colorectal and small intestine cancer in Chinese adults: a prospective study of 0.5 million people.

Pang Y, Kartsonaki C, Guo Y, Chen Y, Yang L, Bian Z, Bragg F, Millwood IY, Mao E, Li Y, Shi L, Chen J, Li L, Holmes MV, Chen Z.

Br J Cancer. 2018 Jun 6. doi: 10.1038/s41416-018-0124-8. [Epub ahead of print]

PMID: 29872150

Abstract

BACKGROUND:

Uncertainty remains about the associations of adiposity with intestinal cancer in China and by its anatomical subtype.

METHODS:

The prospective China Kadoorie Biobank recorded 3024 incident cases of colorectal (CRC) and 143 cases of small intestine (SIC) cancer during a 10-year follow-up among 509 568 participants without prior cancer at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for specific cancers associated with adiposity.

RESULTS:

Overall mean body mass index (BMI) was 23.7  kg/m2. BMI was positively associated with CRC (HR per SD 1.10 [95% CI 1.06-1.14]), colon (1.13 [1.07-1.18]), and rectal (1.07 [1.02-1.13]) cancer. For waist circumference, the corresponding HRs per SD were 1.14 (1.10-1.18), 1.18 (1.13-1.24), and 1.11 (1.05-1.16), respectively. The adjusted HRs were somewhat greater in men than women. Adiposity was positively, but non-significantly, associated with SIC risk.

CONCLUSIONS:

Among relatively lean Chinese adults, adiposity was associated with risks of colon and rectal cancer, with the associations somewhat stronger in men than women.

 

Reducing sitting time versus adding exercise: differential effects on biomarkers of endothelial dysfunction and metabolic risk.

Duvivier BMFM, Bolijn JE, Koster A, Schalkwijk CG, Savelberg HHCM, Schaper NC.

Sci Rep. 2018 Jun 5;8(1):8657. doi: 10.1038/s41598-018-26616-w.

PMID: 29872225 Free Article

Abstract

Recent studies suggest that substituting sitting with light physical activity has beneficial metabolic effects, but it is unclear if this is associated with parallel changes in endothelial function. Data from three randomized cross-over studies were analyzed, in which 61 subjects (with normal weight, overweight and type 2 diabetes) followed different activity regimens (Sit, SitLess and/or Exercise) of four days each. Subjects were instructed to sit 14 h/day ('Sit'), to substitute 1 h/day of sitting with moderate-to-vigorous cycling ('Exercise') or to substitute 5-6 h/day sitting with light-intensity walking and standing ('SitLess'). Physical activity was assessed 24 h/day by accelerometry (ActivPAL) and diet was standardized. Fasted circulating biomarkers of endothelial dysfunction, lipids and insulin sensitivity were assessed the morning after each activity regimen. The endothelial dysfunction score (ED-score) was computed by averaging the Z-scores of the circulating biomarkers of endothelial dysfunction. Compared to Sit, Exercise resulted in lower ED-score, sICAM1 and sE-selectin (p < 0.05), while no significant changes were observed after SitLess. The ED-score, sVCAM1 and sE-selectin were lower after Exercise compared to SitLess (p < 0.05). In contrast, compared to Sit, insulin sensitivity (HOMA2-IR) and plasma lipids (HDL-cholesterol, non-HDL-cholesterol, total cholesterol and Apo B) did not change significantly after Exercise but were improved after SitLess (p < 0.05). In conclusion, light physical activity and moderate-to-vigorous physical activity had a differential effect on risk markers of cardio-metabolic health and suggest the need of both performing structured exercise as well as reducing sitting time on a daily basis.

 

Anatomical subsite can modify the association between meat and meat compounds and risk of colorectal adenocarcinoma: findings from three large US cohorts.

Etemadi A, Abnet CC, Graubard BI, Freeman LB, Freedman ND, Liao L, Dawsey SM, Sinha R.

Int J Cancer. 2018 Jun 6. doi: 10.1002/ijc.31612. [Epub ahead of print]

PMID: 29873077

Abstract

Distal and proximal colon tumors have distinct incidence trends and embryonic origins; whether these sub-sites have distinct susceptibilities to known risk factors is unclear. We used pooled data from 407,270 participants in three US-based studies, with overall median follow-up of 13.8 years. We used adjusted Cox models to analyze the association between dietary intakes (from diet history questionnaire) of total, processed and unprocessed red meat; total white meat, poultry and fish; and meat-related compounds: heme iron, nitrate, nitrite, the heterocyclic amines (HCAs), and benzo(a)pyrene (B(a)P) and incidence of colorectal cancer subsites. The risk of colorectal cancer (n=6,640) increased by 35% for each 50 g/1000 kcal higher daily intake of total red meat, with a significant right-to-left trend from proximal colon (HR:1.24; 95%CI:1.09-1.39) to distal colon (HR:1.34; 95%CI:1.13-1.55) and rectum (HR:1.53; 95%CI:1.28-1.79). Only unprocessed red meat showed a significant right-to-left trend. Each 50 g/1000 kcal increase in white meat intake was associated with a 26% reduction in total colorectal cancer risk (HR: 0.74; 95%CI: 0.68-0.80), with a significant inverse right-to-left trend. The highest quintile of heme iron was associated with increased cancer risk only in the distal colon (HR:1.20; 95%CI: 1.02-1.42) and rectum (HR:1.27; 95%CI: 1.07-1.52). The highest quintile of HCAs, and nitrate/nitrite were associated with increased risk of total colorectal cancer, but these associations did not vary across anatomical subsites. In summary, right and left subsites of the colon may have distinct susceptibilities to meat and possibly other dietary risk factors, suggesting that the causes of colorectal cancer may vary across anatomical subsites.

 

Dietary cholesterol intake and stroke risk: a meta-analysis.

Cheng P, Pan J, Xia J, Deng F, Huang W, Bai S, Zhu X, Shao W, Wang H, Xie P.

Oncotarget. 2018 Jan 4;9(39):25698-25707. doi: 10.18632/oncotarget.23933. eCollection 2018 May 22.

PMID: 29876017

Abstract

BACKGROUND/OBJECTIVES:

The association between dietary cholesterol and stroke risk has remained controversial over the past two decades. The aim of this meta-analysis was to assess the relationship between dietary cholesterol and stroke risk.

RESULTS:

Seven prospective studies including 269,777 non-overlapping individuals (4,604 strokes) were included. The combined RR of stroke for higher cholesterol intake (> 300 mg/day) was 0.98 (95% CI, 0.90-1.07), and the combined RR of stroke for higher cholesterol intake (> 300 mg/day) in females (age of ≥ 60 years or body mass index of ≥ 24 kg/m2) was 1.18 (95% CI, 1.02-1.36).

MATERIALS AND METHODS:

The PubMed, Medline, Embase, Web of Knowledge, and Google Scholar databases were searched. Relevant studies were identified by searching these online databases through September 2017. The relative risk (RR) and 95% confidence interval (CI) were used to investigate the strength of the association.

CONCLUSIONS:

Higher cholesterol intake has no association with the overall stroke risk. Age and body mass index affect the relationship between dietary cholesterol intake and stroke risk. However, the association between higher dietary cholesterol and stroke risk in males remains unclear.

KEYWORDS:

cerebrovascular accident; cholesterol; diet; meta-analysis; stroke

 

Higher dietary glycemic index and glycemic load values increase the risk of osteoporotic fracture in the PREvención con DIeta MEDiterránea (PREDIMED)-Reus trial.

García-Gavilán JF, Bulló M, Camacho-Barcia L, Rosique-Esteban N, Hernández-Alonso P, Basora J, Martínez-González MA, Estruch R, Fitó M, Salas-Salvadó J.

Am J Clin Nutr. 2018 Jun 1;107(6):1035-1042. doi: 10.1093/ajcn/nqy043.

PMID: 29746627

Abstract

BACKGROUND:

High glucose and insulin concentrations seem to have a negative impact on bone health. However, the relation between the dietary glycemic index (DGI) and the dietary glycemic load (DGL), which has proved to be effective at modulating blood glucose concentrations after carbohydrate consumption, has yet to be explored in relation to bone health.

OBJECTIVE:

The aim of the study was to examine the associations between the DGI or DGL and the risk of osteoporotic-related fractures in an elderly Mediterranean population.

DESIGN:

The study was conducted in 870 subjects aged 55-80 y at high cardiovascular disease risk participating in the PREvención con DIeta MEDiterránea (PREDIMED)-Reus study. The DGI and DGL were estimated from validated food-frequency questionnaires with the use of the international glycemic index and glycemic load values, with glucose as reference. Data on osteoporotic fractures were acquired from a systematic review of medical records. We used Cox proportional hazard models to assess the risk of osteoporotic fracture according to tertiles of average DGI and DGL.

RESULTS:

A total of 114 new cases of osteoporotic-related fractures were documented after a mean follow-up of 8.9 y. Participants in the highest tertile of DGI and DGL had a significantly higher risk of osteoporotic fractures than those in the lowest tertile after adjusting for potential confounders (HR: 1.80; 95% CI: 1.03, 3.15 and HR: 3.20; 95% CI: 1.25, 8.18, respectively).

CONCLUSIONS:

A high DGI and DGL are associated with a higher risk of osteoporosis-related fractures in an elderly Mediterranean population at high cardiovascular disease risk. This trial was registered at isrctn.com as ISRCTN35739639.

 

Effects of vitamin D supplementation on markers for cardiovascular disease and type 2 diabetes: an individual participant data meta-analysis of randomized controlled trials.

Swart KM, Lips P, Brouwer IA, Jorde R, Heymans MW, Grimnes G, Grübler MR, Gaksch M, Tomaschitz A, Pilz S, Eiriksdottir G, Gudnason V, Wamberg L, Rejnmark L, Sempos CT, Durazo-Arvizu RA, Dowling KG, Hull G, Škrabáková Z, Kiely M, Cashman KD, van Schoor NM.

Am J Clin Nutr. 2018 Jun 1;107(6):1043-1053. doi: 10.1093/ajcn/nqy078.

PMID: 29868916

Abstract

BACKGROUND:

Evidence from randomized controlled trials (RCTs) for the causal role of vitamin D on noncommunicable disease outcomes is inconclusive.

OBJECTIVE:

The aim of this study was to investigate whether there are beneficial or harmful effects of cholecalciferol (vitamin D3) supplementation according to subgroups of remeasured serum 25-hydroxyvitamin D [25(OH)D] on cardiovascular and glucometabolic surrogate markers with the use of individual participant data (IPD) meta-analysis of RCTs.

DESIGN:

Twelve RCTs (16 wk to 1 y of follow-up) were included. For standardization, 25(OH)D concentrations for all participants (n = 2994) at baseline and postintervention were re-measured in bio-banked serum samples with the use of a certified liquid chromatography-tandem mass spectrometry method traceable to a reference measurement procedure. IPD meta-analyses were performed according to subgroups of remeasured 25(OH)D. Main outcomes were blood pressure and glycated hemoglobin (HbA1c). Secondary outcomes were LDL, HDL, and total cholesterol and triglycerides; parathyroid hormone (PTH); fasting glucose, insulin, and C-peptide; and 2-h glucose. In secondary analyses, other potential effect modifiers were studied.

RESULTS:

Remeasurement of 25(OH)D resulted in a lower mean 25(OH)D concentration in 10 of 12 RCTs. Vitamin D supplementation had no effect on the main outcomes of blood pressure and HbA1c. Supplementation resulted in 10-20% lower PTH concentrations, irrespective of the 25(OH)D subgroups. The subgroup analyses according to achieved 25(OH)D concentrations showed a significant decrease in LDL-cholesterol concentrations after vitamin D supplementation in 25(OH)D subgroups with <75, <100, and <125 nmol of -0.10 mmol/L (95% CI: -0.20, -0.00 mmol/L), -0.10 mmol/L (95% CI: -0.18, -0.02 mmol/L), and -0.07 mmol/L (95% CI: -0.14, -0.00 mmol/L), respectively. Patient features that modified the treatment effect could not be identified.

CONCLUSIONS:

For the main outcomes of blood pressure and HbA1c, the data support no benefit for vitamin D supplementation. For the secondary outcomes, in addition to its effect on PTH, we observed indications for a beneficial effect of vitamin D supplementation only on LDL cholesterol, which warrants further investigation.

 

Effects of exercise and dietary habits on the occurrence of polycystic ovary syndrome over 5 years of follow-up.

Zhang J, Zhou K, Luo L, Liu Y, Liu X, Xu L.

Int J Gynaecol Obstet. 2018 Jun 7. doi: 10.1002/ijgo.12563. [Epub ahead of print]

PMID: 29877578

Abstract

OBJECTIVE:

To evaluate the effects of recent and previous exercise and dietary habits on the occurrence of polycystic ovary syndrome (PCOS).

METHODS:

The present study had a population-based case-control phase and a nested case-control phase. Women aged 12-44 years with and without PCOS were surveyed using the Semiquantitative Food Frequency Questionnaire and the International Physical Activity Questionnaire to evaluate the correlation of PCOS with recent (last 7 days) or previous (5 years ago) exercise and dietary habits.

RESULTS:

No difference in recent physical activity was found between the PCOS and control groups (case-control phase, n=1854). However, patients with PCOS had previously (5 years ago; nested case-control phase, n=1149) spent less time physical active in relation to transportation (P=0.003), housekeeping (P=0.023), walking (P<0.001), and activities of moderate intensity (P=0.008), and had spent more time sitting (P<0.001). Dietary nutrients and energy intake did not differ between the two groups (P>0.05 for all comparisons).

CONCLUSIONS:

A previous exercise habit was associated with subsequent PCOS whereas a recently acquired exercise routine was not. Women should avoid long-term sedentary lifestyle habits and focus on adding to the duration of, or enhancing the intensity of, physical activity. This article is protected by copyright. All rights reserved.

KEYWORDS:

Dietary habits; Nested case-control study; Physical activity; Polycystic ovary syndrome; Population-based case-control study; Sedentary habits

 

Sickness absence diagnoses among abstainers, low-risk drinkers and at-risk drinkers: consideration of the U-shaped association between alcohol use and sickness absence in four cohort studies.

Ervasti J, Kivimäki M, Head J, Goldberg M, Airagnes G, Pentti J, Oksanen T, Salo P, Suominen S, Jokela M, Vahtera J, Zins M, Virtanen M.

Addiction. 2018 Jun 5. doi: 10.1111/add.14249. [Epub ahead of print]

PMID: 29873143

Abstract

AIMS:

To estimate differences in the strength and shape of associations between alcohol use and diagnosis-specific sickness absence.

DESIGN:

A multi-cohort study. Participants (n = 47 520) responded to a survey on alcohol use at two time-points, and were linked to records of sickness absence. Diagnosis-specific sickness absence was followed for 4-7 years from the latter survey.

SETTING AND PARTICIPANTS:

From Finland, we had population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000-02 and 2004. From France and the United Kingdom, we had employee cohort survey data from 1993 and 1997, and 1985-88 and 1991-94, respectively.

MEASUREMENTS:

We used standard questionnaires to assess alcohol intake categorized into 0, 1-11 and > 11 units per week in women and 0, 1-34 and > 34 units per week in men. We identified groups with stable and changing alcohol use over time. We linked participants to records from sickness absence registers. Diagnoses of sickness absence were coded according to the International Classification of Diseases. Estimates were adjusted for sex, age, socio-economic status, smoking and body mass index.

FINDINGS:

Women who reported drinking 1-11 units and men who reported drinking 1-34 units of alcohol per week in both surveys were the reference group. Compared with them, women and men who reported no alcohol use in either survey had a higher risk of sickness absence due to mental disorders [rate ratio = 1.51, 95% confidence interval (CI) = 1.22-1.88], musculoskeletal disorders (1.22, 95% CI = 1.06-1.41), diseases of the digestive system (1.35, 95% CI = 1.02-1.77) and diseases of the respiratory system (1.49, 95% CI = 1.29-1.72). Women who reported alcohol consumption of > 11 weekly units and men who reported alcohol consumption of > 34 units per week in both surveys were at increased risk of absence due to injury or poisoning (1.44, 95% CI = 1.13-1.83).

CONCLUSIONS:

In Finland, France and the United Kingdom, people who report not drinking any alcohol on two occasions several years apart appear to have a higher prevalence of sickness absence from work with chronic somatic and mental illness diagnoses than those drinking below a risk threshold of 11 units per week for women and 34 units per week for men. Persistent at-risk drinking in Finland, France and the United Kingdom appears to be related to increased absence due to injury or poisoning.

KEYWORDS:

Abstaining; at-risk drinking; longitudinal; multi-cohort; pooled data; sick leave

 

Severe energy deficit at high altitude inhibits skeletal muscle mTORC1-mediated anabolic signaling without increased ubiquitin proteasome activity.

Margolis LM, Carbone JW, Berryman CE, Carrigan CT, Murphy NE, Ferrando AA, Young AJ, Pasiakos SM.

FASEB J. 2018 Jun 7:fj201800163RR. doi: 10.1096/fj.201800163RR. [Epub ahead of print]

PMID: 29878853

Abstract

Muscle loss at high altitude (HA) is attributable to energy deficit and a potential dysregulation of anabolic signaling. Exercise and protein ingestion can attenuate the effects of energy deficit on muscle at sea level (SL). Whether these effects are observed when energy deficit occurs at HA is unknown. To address this, muscle obtained from lowlanders ( n = 8 males) at SL, acute HA (3 h, 4300 m), and chronic HA (21 d, -1766 kcal/d energy balance) before [baseline (Base)] and after 80 min of aerobic exercise followed by a 2-mile time trial [postexercise (Post)] and 3 h into recovery (Rec) after ingesting whey protein (25 g) were analyzed using standard molecular techniques. At SL, Post, and REC, p-mechanistic target of rapamycin (mTOR)Ser2448, p-p70 ribosomal protein S6 kinase (p70S6K)Ser424/421, and p-ribosomal protein S6 (rpS6)Ser235/236 were similar and higher ( P < 0.05) than Base. At acute HA, Post p-mTORSer2448 and Post and REC p-p70S6KSer424/421 were not different from Base and lower than SL ( P < 0.05). At chronic HA, Post and Rec p-mTORSer2448 and p-p70S6KSer424/421 were not different from Base and lower than SL, and, independent of time, p-rpS6Ser235/236 was lower than SL ( P < 0.05). Post proteasome activity was lower ( P < 0.05) than Base and Rec, independent of phase. Our findings suggest that HA exposure induces muscle anabolic resistance that is exacerbated by energy deficit during acclimatization, with no change in proteolysis.-Margolis, L. M., Carbone, J. W., Berryman, C. E., Carrigan, C. T., Murphy, N. E., Ferrando, A. A., Young, A. J., Pasiakos, S. M. Severe energy deficit at high altitude inhibits skeletal muscle mTORC1-mediated anabolic signaling without increased ubiquitin proteasome activity.

KEYWORDS:

REDD1; hypoxia; proteolysis; rpS6; weight loss

 

Achieved diastolic blood pressure and pulse pressure at target systolic blood pressure (120-140 mmHg) and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials.

Böhm M, Schumacher H, Teo KK, Lonn E, Mahfoud F, Mann JFE, Mancia G, Redon J, Schmieder R, Weber M, Sliwa K, Williams B, Yusuf S.

Eur Heart J. 2018 Jun 4. doi: 10.1093/eurheartj/ehy287. [Epub ahead of print]

PMID: 29873709

Abstract

AIMS:

Current guidelines of hypertensive management recommend upper limits for systolic (SBP) and diastolic blood pressure (DBP). J-curve associations of BP with risk exist for some outcomes suggesting that lower limits of DBP goals may also apply. We examined the association between mean attained DBP and cardiovascular (CV) outcomes in patients who achieved an on-treatment SBP in the range of 120 to <140 mmHg in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomized AssessmeNt Study in ACE iNtolerant participants with cardiovascular Disease (TRANSCEND) trials on patients with high CV risk. This SBP range was associated with the lowest CV risk.

METHODS:

We analysed the outcome data from patients age 55 years or older with CV disease from the ONTARGET and TRANSCEND trials that randomized high-risk patients to ramipril, telmisartan, and the combination. In patients with controlled SBP (on-treatment 120 to <140 mmHg), the composite outcome of CV death, myocardial infarction, stroke and hospital admission for heart failure, the components thereof, and all-cause mortality were analysed according to mean on-treatment DBP as categorical (<70, 70 to <80, 80 to <90, and ≥90 mmHg) and continuous variable as well as the change of DBP according to baseline DBP. Pulse pressure (PP) was related to outcomes as a continuous variable.

RESULTS:

In 16 099 of 31 546 patients, mean achieved SBP was 120 to <140 mmHg. The nominally lowest risk for all outcomes was observed at an achieved DBP of 70 to <80 mmHg. A higher achieved DBP was associated with a higher risk for the outcomes of stroke and of hospitalization for heart failure (≥80 mmHg) and myocardial infarction (≥90 mmHg). A lower achieved DBP (<70 mmHg) was associated with a higher risk for the primary outcome [hazard ratio (HR) 1.29, 95% confidence interval (95% CI) 1.15-1.45; P < 0.0001], myocardial infarction HR 1.54 (95% CI 1.26-1.88, P < 0.0001) and hospitalization for heart failure HR 1.81 (95% CI 1.47-2.24, P < 0.0001) and all-cause death (HR 1.19, 95% CI 1.04-1.35; P < 0.0001) while there was no signal for stroke and CV death compared to DBP 70 to <80 mmHg. A decrease of DBP was associated with lower risk when baseline DBP was >80 mmHg. The associations to outcomes were similar when patients were divided to SBP 120 to <130 mmHg or 130 to <140 mmHg for DBP or PP.

CONCLUSION:

Compared to a DBP of 70 to <80 mmHg, lower and higher DBP was associated with a higher risk in patients achieving a SBP of 120 to <140 mmHg. Associations of DBP and PP to risk were similar notably at controlled SBP. These data suggest at optimal achieved SBP, risk is still defined by low or high DBP. These findings support guidelines which take DBP at optimal SBP control into consideration.

 

The effect of vitamin B12 and folic acid supplementation on routine haematological parameters in older people: an individual participant data meta-analysis.

Smelt AF, Gussekloo J, Bermingham LW, Allen E, Dangour AD, Eussen SJ, Favrat B, De Groot LC, Kok FJ, Kwok T, Mangoni AA, Ntaios G, Van De Rest O, Seal E, Vaucher P, Verhoef P, Stijnen T, Den Elzen WP.

Eur J Clin Nutr. 2018 Jun;72(6):785-795. doi: 10.1038/s41430-018-0118-x. Epub 2018 Mar 8. Review.

PMID: 29520083

Abstract

BACKGROUND/OBJECTIVES:

Low vitamin B12 and folate levels in community-dwelling older people are usually corrected with supplements. However, the effect of this supplementation on haematological parameters in older persons is not known. Therefore, we executed a systematic review and individual participant data meta-analysis of randomised placebo-controlled trials (RCTs).

SUBJECTS/METHODS:

We performed a systematic search in PubMed, EMBASE, Web of Science, Cochrane and CENTRAL for RCTs published between January 1950 and April 2016, where community-dwelling elderly (60+ years) who were treated with vitamin B12 or folic acid or placebo. The presence of anaemia was not required. We analysed the data on haematological parameters with a two-stage IPD meta-analysis.

RESULTS:

We found 494 full papers covering 14 studies. Data were shared by the authors of four RCTs comparing vitamin B12 with placebo (n = 343) and of three RCTs comparing folic acid with placebo (n = 929). We found no effect of vitamin B12 supplementation on haemoglobin (change 0.00 g/dL, 95% CI: -0.19;0.18), and no effect of folic acid supplementation (change -0.09 g/dL, 95% CI: -0.19;0.01). The effects of supplementation on other haematological parameters were similar. The effects did not differ by sex or by age group. Also, no effect was found in a subgroup of patients with anaemia and a subgroup of patients who were treated >4 weeks.

CONCLUSIONS:

Evidence on the effects of supplementation of low concentrations of vitamin B12 and folate on haematological parameters in community-dwelling older people is inconclusive. Further research is needed before firm recommendations can be made concerning the supplementation of vitamin B12 and folate.

 

Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials.

Nichol AD, Holle MJ, An R.

Eur J Clin Nutr. 2018 May 15. doi: 10.1038/s41430-018-0170-6. [Epub ahead of print]

PMID: 29760482

Abstract

BACKGROUND/OBJECTIVES:

Nonnutritive sweeteners (NNSs) are zero- or low-calorie alternatives to nutritive sweeteners, such as table sugars. A systematic review and meta-analysis of randomized controlled trials was conducted to quantitatively synthesize existing scientific evidence on the glycemic impact of NNSs.

SUBJECTS/METHODS:

PubMed and Web of Science databases were searched. Two authors screened the titles and abstracts of candidate publications. The third author was consulted to resolve discrepancies. Twenty-nine randomized controlled trials, with a total of 741 participants, were included and their quality assessed. NNSs under examination included aspartame, saccharin, steviosides, and sucralose. The review followed the PRISMA guidelines.

RESULTS:

Meta-analysis was performed to estimate and track the trajectory of blood glucose concentrations over time after NNS consumption, and to test differential effects by type of NNS and participants' age, weight, and disease status. In comparison with the baseline, NNS consumption was not found to increase blood glucose level, and its concentration gradually declined over the course of observation following NNS consumption. The glycemic impact of NNS consumption did not differ by type of NNS but to some extent varied by participants' age, body weight, and diabetic status.

CONCLUSIONS:

NNS consumption was not found to elevate blood glucose level. Future studies are warranted to assess the health implications of frequent and chronic NNS consumption and elucidate the underlying biological mechanisms.

 

Effect of omega-3 long-chain polyunsaturated fatty acid supplementation on heart rate: a meta-analysis of randomized controlled trials.

Hidayat K, Yang J, Zhang Z, Chen GC, Qin LQ, Eggersdorfer M, Zhang W.

Eur J Clin Nutr. 2018 Jun;72(6):805-817. doi: 10.1038/s41430-017-0052-3. Epub 2017 Dec 28. Review.

PMID: 29284786

Abstract

BACKGROUND:

Elevated resting heart rate (HR) has emerged as a new risk factor for all-cause and cardiovascular mortality. The effect of marine-derived omega-3 long-chain polyunsaturated fatty acid (n-3 LCPUFAs) supplementation on HR was investigated as an outcome in many clinical trials. The present study was to provide an updated meta-analysis on the HR-slowing effect of n-3 LCPUFAs, and to differentiate the chronotropic effect between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

METHODS:

PubMed and Cochrane databases were searched for relevant articles examining the effects of n-3 PUFAs on HR through May 2017. A random-effects model was used to generate the pooled effect sizes and 95% confidence intervals (CIs). The pooled effect sizes were presented as weighted mean differences (WMDs).

RESULTS:

A total of 51 randomized controlled trials (RCTs) with approximately 3000 participants were included in this meta-analysis. Compared to placebo, n-3 PUFA supplementation mildly but significantly reduced HR (-2.23 bpm; 95% CI: -3.07, -1.40 bpm). Moderate evidence of heterogeneity was observed among included trials (I 2 = 49.1%, P heterogeneity < 0.001). When DHA and EPA were separately administered, modest HR reduction was observed in trials that supplemented with DHA (-2.47 bpm; 95% CI: -3.47, -1.46 bpm), but not in trials with EPA.

CONCLUSIONS:

The present meta-analysis provides strong clinical evidence demonstrating the effect of heart rate reduction by n-3 LCPUFA supplementation. When DHA or EPA administered alone, heart rate was slowed by DHA rather than by EPA.

 

Re-evaluation of the associations of egg intake with serum total cholesterol and cause-specific and total mortality in Japanese women.

Nakamura Y, Okamura T, Kita Y, Okuda N, Kadota A, Miura K, Okayama A, Ueshima H; NIPPON DATA90 Research Group.

Eur J Clin Nutr. 2018 Jun;72(6):841-847. doi: 10.1038/s41430-017-0051-4. Epub 2017 Dec 29.

PMID: 29288244

Abstract

BACKGROUND/OBJECTIVE:

Egg intake was associated with serum total cholesterol adjusted for age (aTCH) and total mortality in women, but not in men, using data from NIPPON DATA (ND) 80 which followed up for 14 years. Re-evaluation of these associations in a different cohort is needed.

SUBJECT/METHODS:

We analyzed the associations of egg intake with aTCH and cause-specific and total mortality using the ND90 data set with a 15-year follow-up. A nutritional examination was done at the baseline in 1990 using the food-frequency method and by weighed food records. We followed 4686 female participants (ages ≥30 years), with no history of stroke or myocardial infarction (mean age 52.8 years) for 15 years.

RESULTS:

The participants were divided into 5 egg intake groups (<1/w, 1-2/w, 1/2d, 1/d, and ≥2/d). There were 203, 1462, 1594, 1387, and 40 women in each group, respectively. Egg intake was not associated with aTCH (P = 0.886). There were 183 cardiovascular disease (CVD), 210 cancer, and 599 total mortality cases during follow-up. Cox analysis, adjusted for background factors, found egg intake was directly associated with total and cancer mortality (HR in the ≥2/d vs. the 1 egg/d group: total, 2.05 (95% CI: 1.20-3.52); cancer, 3.20 (1.51-6.76)), and that cancer mortality in the 1-2/w group was significantly less than that in the 1 egg/d group (0.68 (0.47-0.97)). Egg intake was not associated with CVD mortality.

CONCLUSIONS:

Egg intake was associated with cancer and total mortality. Reducing egg intake may have some definitive health benefits in women in Japan, at least.

 

A prospective cohort study of meat and fish consumption and endometriosis risk.

Yamamoto A, Harris HR, Vitonis AF, Chavarro JE, Missmer SA.

Am J Obstet Gynecol. 2018 Jun 2. pii: S0002-9378(18)30444-7. doi: 10.1016/j.ajog.2018.05.034. [Epub ahead of print]

PMID: 29870739

Abstract

BACKGROUND:

Only two case-control studies have examined the associations between consumption of meat products and endometriosis risk with inconsistent results. Consumption of animal products has the potential to influence endometriosis risk through effects on steroid hormones levels.

OBJECTIVES:

To determine whether higher intake of red meat, poultry, fish, and seafood are associated with risk of laparoscopically-confirmed endometriosis STUDY DESIGN: 81,908 participants of the prospective Nurses' Health Study II were followed from 1991-2013. Diet was assessed via food frequency questionnaire every 4 years. Cox proportional hazards models were used to calculate rate ratios (RR) and 95% confidence intervals (CIs).

RESULTS:

During 1,019,294 person-years of follow-up, 3,800 cases of incident laparoscopically-confirmed endometriosis were reported. Women consuming >2 servings/day of red meat/day had a 56% higher risk in endometriosis (95% CI=1.22-1.99; Ptrend<0.0001) compared to those consuming ≤1 serving/week. This association was strongest for non-processed red meats (RR=1.57; 95% CI= 1.35-1.83 for ≥2 servings/day versus ≤1 servings/week; Ptrend<0.0001), particularly among women had not reported infertility (pinteraction=0.0004). Women in the highest category of processed red meat intake also had a higher risk of endometriosis (RR=1.20; 95% CI=1.06-1.37 for ≥5 servings/week versus <1 serving/month; Ptrend=0.02). Intakes of poultry, fish, shellfish, and eggs were unrelated to endometriosis risk.

CONCLUSIONS:

Our prospective analysis among premenopausal US nurses suggests that red meat consumption may be an important modifiable risk factor for endometriosis, particularly among women with endometriosis who had not reported infertility and thus were more likely to present with pain symptoms. Well-designed dietary intervention studies among women with endometriosis could help confirm this observation.

KEYWORDS:

diet; endometriosis; meat

 

Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community.

Ohara T, Honda T, Hata J, Yoshida D, Mukai N, Hirakawa Y, Shibata M, Kishimoto H, Kitazono T, Kanba S, Ninomiya T.

J Am Geriatr Soc. 2018 Jun 6. doi: 10.1111/jgs.15446. [Epub ahead of print]

PMID: 29873398

Abstract

OBJECTIVES:

To investigate the association between daily sleep duration and risk of dementia and death in a Japanese elderly population.

DESIGN:

Prospective cohort study.

SETTING:

The Hisayama Study, Japan.

PARTICIPANTS:

Community-dwelling Japanese individuals aged 60 and older without dementia.

MEASUREMENTS:

Self-reported daily sleep duration was grouped into 5 categories (<5.0, 5.0-6.9, 7.0-7.9, 8.0-9.9, ≥10.0 hours). The association between daily sleep duration and risk of dementia and death was determined using a Cox proportional hazards models.

RESULTS:

During follow-up, 294 participants developed dementia, and 282 died. Age- and sex-adjusted incidence rates of dementia and all-cause mortality were significantly greater in subjects with daily sleep duration of less than 5.0 hours and 10.0 hours and more than in those with daily sleep duration of 5.0 to 6.9 hours. These associations remained unchanged after adjustment for potential confounding factors (<5.0 hours: hazard ratio (HR)=2.64, 95% confidence interval (CI)=1.38-5.05 for dementia; HR=2.29, 95% CI=1.15-4.56 for death; ≥10.0 hours: HR=2.23, 95% CI=1.42-3.49 for dementia; HR=1.67, 95% CI=1.07-2.60 for death). Similar U-shaped associations were observed for Alzheimer's disease and vascular dementia. With regard to the influence of hypnotic use on risk of dementia and death, subjects who used hypnotics and had any sleep duration had a risk of dementia that was 1.66 times as great and a risk of death that was 1.83 times as great as those who did not use hypnotics and had a daily sleep duration of 5.0 to 6.9 hours.

CONCLUSION:

Short and long daily sleep duration and hypnotic use are risk factors for dementia and death in Japanese elderly adults.

KEYWORDS:

Alzheimer's disease; all sleep disorders; dementia; epidemiology; risk factors; vascular dementia

 

Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study.

Lv YB, Gao X, Yin ZX, Chen HS, Luo JS, Brasher MS, Kraus VB, Li TT, Zeng Y, Shi XM.

BMJ. 2018 Jun 5;361:k2158. doi: 10.1136/bmj.k2158.

PMID: 29871897

https://www.bmj.com/content/bmj/361/bmj.k2158.full.pdf

Abstract

OBJECTIVE:

To examine the associations of blood pressure with all cause mortality and cause specific mortality at three years among oldest old people in China.

DESIGN:

Community based, longitudinal prospective study.

SETTING:

2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, conducted in 22 Chinese provinces.

PARTICIPANTS:

4658 oldest old individuals (mean age 92.1 years).

MAIN OUTCOME MEASURES:

All cause mortality and cause specific mortality assessed at three year follow-up.

RESULTS:

1997 deaths were recorded at three year follow-up. U shaped associations of mortality with systolic blood pressure, mean arterial pressure, and pulse pressure were identified; values of 143.5 mm Hg, 101 mm Hg, and 66 mm Hg conferred the minimum mortality risk, respectively. After adjustment for covariates, the U shaped association remained only for systolic blood pressure (minimum mortality risk at 129 mm Hg). Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased for values lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58)). In the cause specific analysis, compared with a middle range of systolic blood pressure (107-154 mm Hg), higher values (>154 mm Hg) were associated with a higher risk of cardiovascular mortality (adjusted hazard ratio 1.51 (95% confidence interval 1.12 to 2.02)); lower values (<107 mm Hg) were associated with a higher risk of non-cardiovascular mortality (1.58 (1.26 to 1.98)). The U shaped associations remained in sensitivity and subgroup analyses.

CONCLUSIONS:

This study indicates a U shaped association between systolic blood pressure and all cause mortality at three years among oldest old people in China. This association could be explained by the finding that higher systolic blood pressure predicted a higher risk of death from cardiovascular disease, and that lower systolic blood pressure predicted a higher risk of death from non-cardiovascular causes. These results emphasise the importance of revisiting blood pressure management or establishing specific guidelines for management among oldest old individuals.

 

Subjective Sleep Quality is not Associated with Incident Dementia: The Rotterdam Study.

Lysen TS, Wolters FJ, Luik AI, Ikram MK, Tiemeier H, Ikram MA.

J Alzheimers Dis. 2018 May 31. doi: 10.3233/JAD-180055. [Epub ahead of print]

PMID: 29865066

Abstract

BACKGROUND:

Poor sleep is related to higher dementia risk, but this association is more equivocal for subjective sleep quality specifically. This study investigates the link between subjective sleep quality and dementia risk in the general population.

OBJECTIVE:

To study the role of subjective sleep quality in the risk of dementia in the general population.

METHODS:

In the prospective population-based Rotterdam Study, 4,835 persons (mean age 72 years, 58% women) underwent a home interview (2002- 2006) that included the validated Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Participants were followed until 2015 for incident dementia, through in-person screening and continuous monitoring of medical records. We used Cox regression models to associate sleep quality with dementia risk, adjusting for age, sex, education, smoking, employment, coffee consumption, alcohol consumption, activities of daily living, cardiovascular risk factors, anxiety, depressive symptoms, cognition, and snoring.

RESULTS:

During 41,385 person-years (8.5 years mean), 420 participants developed dementia, of whom 320 Alzheimer's disease (AD). Poorer subjective sleep quality was not associated with the risk of all-cause dementia (hazard ratio {HR} per SD increase in PSQI score: 0.91, 95% CI 0.82- 1.02) or AD (HR 0.92, 95% CI 0.81- 1.05). Similarly, individual components of the PSQI were also not associated with dementia. Several sensitivity analyses, i.e., excluding last years of the follow-up time duration or restricting to those with best MMSE scores at baseline, did not reveal subgroups with increased risks.

CONCLUSION:

In this study, we found no association of poor subjective sleep quality with higher risk of dementia.

KEYWORDS:

Alzheimer’s disease; cognition; dementia; epidemiology; sleep

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Sleep quality and 1-year incident cognitive impairment in community-dwelling older adults.

Potvin O, Lorrain D, Forget H, Dubé M, Grenier S, Préville M, Hudon C.

Sleep. 2012 Apr 1;35(4):491-9. doi: 10.5665/sleep.1732.

PMID: 22467987 Free PMC Article

Abstract

STUDY OBJECTIVES:

To examine in cognitively intact older men and women the associations between subjective sleep quality and 1-yr incident cognitive impairment.

DESIGN:

Prospective cohort study.

SETTING:

General community.

PARTICIPANTS:

1,664 cognitively intact individuals age 65 to 96 years.

MEASUREMENTS AND RESULTS:

Sleep quality at baseline was measured using the Pittsburgh Sleep Quality Index (PSQI). Cognitive functioning was assessed at baseline and 12 months later using the Mini-Mental State Examination (MMSE). Incident general cognitive impairment was defined according to a follow-up MMSE score below the 15(th) percentile according to normative data and of at least 2 points below baseline. General cognitive impairments were also separated into amnestic and nonamnestic subtypes according to MMSE delayed recall performance. Associations between sleep quality indicators at baseline and incident cognitive impairment were assessed by odds ratio (OR) adjusted for age, education, baseline MMSE score, psychotropic drug use, anxiety, depressive episodes, cardiovascular conditions, and chronic diseases. Results revealed that global PSQI score was significantly linked with incident cognitive impairment (OR 1.17, 95% confidence interval (CI) 1.05-1.30) in men, but not in women. In women, sleep disturbance score (OR 2.62, 95% CI 1.41-4.86) and long sleep duration (≥ 9 hr; OR 3.70, 95% CI 1.49-9.17) were associated with nonamnestic and amnestic incident cognitive impairment, respectively. In men, short sleep duration (≤ 5 hr; OR 4.95, 95% CI 1.72-14.27) and habitual sleep efficiency score (OR 1.94, 95% CI 1.42-2.66) were associated with amnestic and general incident cognitive impairment, respectively.

CONCLUSIONS:

Sleep quality in older adults should receive particular attention by clinicians because poor sleep quality can be an early sign of cognitive decline.

KEYWORDS:

Sleep quality; cognition; cognitive decline; elderly

 

Assessing Statewide All-Cause Future One-Year Mortality: Prospective Study With Implications for Quality of Life, Resource Utilization, and Medical Futility.

Guo Y, Zheng G, Fu T, Hao S, Ye C, Zheng L, Liu M, Xia M, Jin B, Zhu C, Wang O, Wu Q, Culver DS, Alfreds ST, Stearns F, Kanov L, Bhatia A, Sylvester KG, Widen E, McElhinney DB, Ling XB.

J Med Internet Res. 2018 Jun 4;20(6):e10311. doi: 10.2196/10311.

PMID: 29866643

https://asset.jmir.pub/assets/c75fa5385983c768c0cc463cd1ceff39.pdf

Abstract

BACKGROUND:

For many elderly patients, a disproportionate amount of health care resources and expenditures is spent during the last year of life, despite the discomfort and reduced quality of life associated with many aggressive medical approaches. However, few prognostic tools have focused on predicting all-cause 1-year mortality among elderly patients at a statewide level, an issue that has implications for improving quality of life while distributing scarce resources fairly.

OBJECTIVE:

Using data from a statewide elderly population (aged ≥65 years), we sought to prospectively validate an algorithm to identify patients at risk for dying in the next year for the purpose of minimizing decision uncertainty, improving quality of life, and reducing futile treatment.

METHODS:

Analysis was performed using electronic medical records from the Health Information Exchange in the state of Maine, which covered records of nearly 95% of the statewide population. The model was developed from 125,896 patients aged at least 65 years who were discharged from any care facility in the Health Information Exchange network from September 5, 2013, to September 4, 2015. Validation was conducted using 153,199 patients with same inclusion and exclusion criteria from September 5, 2014, to September 4, 2016. Patients were stratified into risk groups. The association between all-cause 1-year mortality and risk factors was screened by chi-squared test and manually reviewed by 2 clinicians. We calculated risk scores for individual patients using a gradient tree-based boost algorithm, which measured the probability of mortality within the next year based on the preceding 1-year clinical profile.

RESULTS:

The development sample included 125,896 patients (72,572 women, 57.64%; mean 74.2 [sD 7.7] years). The final validation cohort included 153,199 patients (88,177 women, 57.56%; mean 74.3 [sD 7.8] years). The c-statistic for discrimination was 0.96 (95% CI 0.93-0.98) in the development group and 0.91 (95% CI 0.90-0.94) in the validation cohort. The mortality was 0.99% in the low-risk group, 16.75% in the intermediate-risk group, and 72.12% in the high-risk group. A total of 99 independent risk factors (n=99) for mortality were identified (reported as odds ratios; 95% CI). Age was on the top of list (1.41; 1.06-1.48); congestive heart failure (20.90; 15.41-28.08) and different tumor sites were also recognized as driving risk factors, such as cancer of the ovaries (14.42; 2.24-53.04), colon (14.07; 10.08-19.08), and stomach (13.64; 3.26-86.57). Disparities were also found in patients' social determinants like respiratory hazard index (1.24; 0.92-1.40) and unemployment rate (1.18; 0.98-1.24). Among high-risk patients who expired in our dataset, cerebrovascular accident, amputation, and type 1 diabetes were the top 3 diseases in terms of average cost in the last year of life.

CONCLUSIONS:

Our study prospectively validated an accurate 1-year risk prediction model and stratification for the elderly population (≥65 years) at risk of mortality with statewide electronic medical record datasets. It should be a valuable adjunct for helping patients to make better quality-of-life choices and alerting care givers to target high-risk elderly for appropriate care and discussions, thus cutting back on futile treatment.

KEYWORDS:

One-year mortality risk prediction; electronic medical records; healthcare resource utilization; quality of life; social determinants

 

Nutritional Intervention as a Preventive Approach for Cognitive-Related Outcomes in Cognitively Healthy Older Adults: A Systematic Review.

Solfrizzi V, Agosti P, Lozupone M, Custodero C, Schilardi A, Valiani V, Sardone R, Dibello V, Di Lena L, Lamanna A, Stallone R, Bellomo A, Greco A, Daniele A, Seripa D, Sabbà C, Logroscino G, Panza F.

J Alzheimers Dis. 2018 May 26. doi: 10.3233/JAD-179940. [Epub ahead of print]

PMID: 29865058

Abstract

The link diet-cognitive function/dementia has been largely investigated in observational studies; however, there was a lack of evidence from randomized clinical trials (RCTs) on the prevention of late-life cognitive disorders though dietary intervention in cognitively healthy older adults. In the present article, we systematically reviewed RCTs published in the last four years (2014-2017) exploring nutritional intervention efficacy in preventing the onset of late-life cognitive disorders and dementia in cognitively healthy subjects aged 60 years and older using different levels of investigation (i.e., dietary pattern changes/medical food/nutraceutical supplementation/multidomain approach and dietary macro- and micronutrient approaches) as well as possible underlying mechanisms of nutritional prevention. From the 35 included RCTs, there was moderate evidence that intervention through dietary pattern changes, medical food/nutraceutical supplementation, and multidomain approach improved specific cognitive domains or cognitive-related blood biomarkers. There was high evidence that protein supplementation improved specific cognitive domains or functional status in prefrail older adults without effect.

KEYWORDS:

Alzheimer’s disease; Mediterranean diet; dementia; dietary pattern; healthy diet; macronutrients; medical food; micronutrients; mild cognitive impairment; nutraceuticals; prevention

 

Mastication of Nuts under Realistic Eating Conditions: Implications for Energy Balance.

McArthur BM, Mattes RD, Considine RV.

Nutrients. 2018 Jun 1;10(6). pii: E710. doi: 10.3390/nu10060710.

PMID: 29865169

http://www.mdpi.com/2072-6643/10/6/710/htm

Edited by AlPater

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Exercise attenuates age-associated changes in motoneuron number, nucleocytoplasmic transport proteins and neuromuscular health.

Gillon A, Nielsen K, Steel C, Cornwall J, Sheard P.

Geroscience. 2018 Apr;40(2):177-192. doi: 10.1007/s11357-018-0020-4. Epub 2018 May 7.

PMID: 29736782 Free PMC Article

Abstract

Life expectancy continues to extend, although frailty caused by loss of skeletal muscle mass continues unimpeded. Muscle atrophy caused by withdrawal of motor nerves is a feature of old age, as it is in amyotrophic lateral sclerosis (ALS) in which skeletal muscle denervation results from motoneuron death. In ALS, direct links have been established between motoneuron death and altered nucleocytoplasmic transport, so we ask whether similar defects accompany motoneuron death in normal ageing. We used immunohistochemistry on mouse tissues to explore potential links between neuromuscular junction (NMJ) degeneration, motoneuron death and nucleocytoplasmic transport regulatory proteins. Old age brought neuromuscular degeneration, motoneuron loss and reductions in immunodetectable levels of key nucleocytoplasmic transport proteins in lumbar motoneurons. We then asked whether exercise inhibited these changes and found that active elderly mice experienced less motoneuron death, improved neuromuscular junction morphology and retention of key nucleocytoplasmic transport proteins in lumbar motoneurons. Our results suggest that emergent defects in nucleocytoplasmic transport may contribute to motoneuron death and age-related loss of skeletal muscle mass, and that these defects may be reduced by exercise.

KEYWORDS:

Ageing; Motoneuron death; Nucleocytoplasmic transport; Sarcopenia

 

Hydrogen sulfide ameliorates aging-associated changes in the kidney.

Lee HJ, Feliers D, Barnes JL, Oh S, Choudhury GG, Diaz V, Galvan V, Strong R, Nelson J, Salmon A, Kevil CG, Kasinath BS.

Geroscience. 2018 Apr;40(2):163-176. doi: 10.1007/s11357-018-0018-y. Epub 2018 May 1.

PMID: 29717417 Free PMC Article

Abstract

Aging is associated with replacement of normal kidney parenchyma by fibrosis. Because hydrogen sulfide (H2S) ameliorates kidney fibrosis in disease models, we examined its status in the aging kidney. In the first study, we examined kidney cortical H2S metabolism and signaling pathways related to synthesis of proteins including matrix proteins in young and old male C57BL/6 mice. In old mice, increase in renal cortical content of matrix protein involved in fibrosis was associated with decreased H2S generation and AMPK activity, and activation of insulin receptor (IR)/IRS-2-Akt-mTORC1-mRNA translation signaling axis that can lead to increase in protein synthesis. In the second study, we randomized 18-19 month-old male C57BL/6 mice to receive 30 μmol/L sodium hydrosulfide (NaHS) in drinking water vs. water alone (control) for 5 months. Administration of NaHS increased plasma free sulfide levels. NaHS inhibited the increase in kidney cortical content of matrix proteins involved in fibrosis and ameliorated glomerulosclerosis. NaHS restored AMPK activity and inhibited activation of IR/IRS-2-Akt-mTORC1-mRNA translation axis. NaHS inhibited age-related increase in kidney cortical content of p21, IL-1β, and IL-6, components of the senescence-associated secretory phenotype. NaHS abolished increase in urinary albumin excretion seen in control mice and reduced serum cystatin C levels suggesting improved glomerular clearance function. We conclude that aging-induced changes in the kidney are associated with H2S deficiency. Administration of H2S ameliorates aging-induced kidney changes probably by inhibiting signaling pathways leading to matrix protein synthesis.

KEYWORDS:

AMP-activated protein kinase; Insulin receptor signaling; Mechanistic target of rapamycin; Protein chemistry

 

Urinary Iodine Concentrations and Mortality Among U.S. Adults.

Inoue K, Leung AM, Sugiyama T, Tsujimoto T, Makita N, Nangaku M, Ritz BR.

Thyroid. 2018 Jun 8. doi: 10.1089/thy.2018.0034. [Epub ahead of print]

PMID: 29882490

Abstract

BACKGROUND:

Iodine deficiency has long been recognized as an important public health problem. Global approaches such as salt iodization that aim to overcome iodine deficiency have been successful. Meanwhile, they have led to excessive iodine consumption in some populations, thereby increasing the risks of iodine-induced thyroid dysfunction, as well as the comorbidities and mortality associated with hypothyroidism and hyperthyroidism. We aimed to elucidate whether iodine intake is associated with mortality among U.S. adults.

METHODS:

This is an observational study to estimate mortality risks according to urinary iodine concentrations (UIC) utilizing a nationally representative sample of 12,264 adults ages 20 to 80 years enrolled in the National Health and Nutrition Examination Survey (NHANES) III. Crude and multivariable Cox proportional hazards regression models were employed to investigate the association between UIC (<50, 50-99, 100-299, 300-399, and >400 μg/L) and mortalities (all-cause, cardiovascular, and cancer). In sensitivity analyses, we adjusted for total sodium intake and fat/calorie ratio in addition to other potential confounders. We also conducted stratum-specific analyses to estimate the effects of UIC on mortality according to age, sex, race/ethnicity, and eGFR category.

RESULTS:

Over a median follow-up of 19.2 years, there were 3,159 deaths from all causes. Participants with excess iodine exposure (UIC >400 μg/L) were at higher risk for all-cause mortality compared to those with adequate iodine nutrition (HR, 1.19; 95% confidence interval [CI], 1.04-1.37). We also found elevated HRs of cardiovascular and cancer mortality, but the 95% CI of our effect estimates included the null value for both outcomes. Low UIC was not associated with increased mortality. Restricted cubic spline models showed similar results for all outcomes. The results did not change substantially after adjusting for total sodium intake and fat/calorie ratio. None of the potential interactions were statistically significant on a multiplicative scale.

CONCLUSION:

Higher all-cause mortality among those with excess iodine intake, compared with individuals with adequate iodine intake, highlights the importance of monitoring population iodine status. Further studies with longitudinal measures of iodine status are needed to validate our results and assess the potential risks excess iodine intake may have on long-term health outcomes.

 

NAD metabolism: Implications in aging and longevity.

Yaku K, Okabe K, Nakagawa T.

Ageing Res Rev. 2018 Jun 5. pii: S1568-1637(18)30006-0. doi: 10.1016/j.arr.2018.05.006. [Epub ahead of print] Review.

PMID: 29883761

Abstract

Nicotinamide adenine dinucleotide (NAD) is an important co-factor involved in numerous physiological processes, including metabolism, post-translational protein modification, and DNA repair. In living organisms, a careful balance between NAD production and degradation serves to regulate NAD levels. Recently, a number of studies have demonstrated that NAD levels decrease with age, and the deterioration of NAD metabolism promotes several aging-associated diseases, including metabolic and neurodegenerative diseases and various cancers. Conversely, the upregulation of NAD metabolism, including dietary supplementation with NAD precursors, has been shown to prevent the decline of NAD and exhibits beneficial effects against aging and aging-associated diseases. In addition, many studies have demonstrated that genetic and/or nutritional activation of NAD metabolism can extend the lifespan of diverse organisms. Collectively, it is clear that NAD metabolism plays important roles in aging and longevity. In this review, we summarize the basic functions of the enzymes involved in NAD synthesis and degradation, as well as the outcomes of their dysregulation in various aging processes. In addition, a particular focus is given on the role of NAD metabolism in the longevity of various organisms, with a discussion of the remaining obstacles in this research field.

KEYWORDS:

Aging; Aging-associated disease; NAD; Nampt; Nmnat; longevity

 

Roundtable discussion: Dietary fats in prevention of atherosclerotic cardiovascular disease.

Severson T, Kris-Etherton PM, Robinson JG, Guyton JR.

J Clin Lipidol. 2018 May - Jun;12(3):574-582. doi: 10.1016/j.jacl.2018.05.006. Epub 2018 May 14. Review.

PMID: 29880281

https://sci-hub.tw/

Abstract

This roundtable discussion on dietary fats was inspired by a recent Presidential Advisory from the American Heart Association giving recommendations about dietary fats for prevention of atherosclerotic cardiovascular disease. The Advisory clarifies a long-held position that saturated fat should be reduced in the American diet. New studies and meta-analyses have questioned the adverse role of saturated fat. The Advisory adds a crucial clarification based primarily on 4 randomized controlled diet trials, each conducted over 4 to 8 years during the 1960s extending to the 1970s. In each trial, saturated fat was reduced and replaced by vegetable oil rich in polyunsaturated fat (PUFA). Meta-analysis showed 29% reduction in major coronary events in the groups receiving PUFAs. Randomized clinical trials provide the best kind of evidence. Replacing saturated fat with PUFA reduces cardiovascular events. Replacing saturated fats with carbohydrates or trans fats does not reduce cardiovascular events. Cardiovascular risk reduction has also been seen in randomized trials with monounsaturated fat in the context of whole food diets, mostly plant based (Mediterranean diets). In this discussion, we additionally cover some of the roller-coaster history of recommendations concerning dietary fat and provide advice for practical counseling.

KEYWORDS:

Atherosclerotic cardiovascular disease; Dietary fats; Monounsaturated fat; Polyunsaturated fat; Saturated fat

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Food deprivation reduces the susceptibility to size-contrast illusions.

Zitron-Emanuel N, Ganel T.

Appetite. 2018 Jun 6. pii: S0195-6663(18)30001-1. doi: 10.1016/j.appet.2018.06.006. [Epub ahead of print]

PMID: 29885383

Abstract

Hunger, caused by mild amount of food deprivation, is an everyday physiological state familiar to us all. Ongoing research has pinpointed the way hunger affects peoples' physiological functions as well as their attitudes and allocation of attention toward domain-specific, food-related objects. Yet, little is known about the way food deprivation affects basic perceptual abilities. Here, we utilized size-contrast visual illusions commonly associated with food to explore the way deprivation affects relative processing of food size. In two experiments (Nexp1 = 32 females, mean age: 24.31; Nexpt2 = 41 females, 40 males, mean age: 23.84), we examined the effect food deprivation has on participants' susceptibility to the Delboeuf illusion, which biases the perceived size of a neutral or of a food-related object when it is placed within the context of another object (e.g., a pizza is perceived as smaller when placed on a larger plate or tray). The results showed that food deprivation reduces the illusory bias for food-related but not for neutral stimuli. Such reduction in the illusory effect indicates reliance on analytic, rather than on relative processing style, for domain-specific stimuli when in the state of hunger.

KEYWORDS:

Delboeuf illusion; Food deprivation; Motivational effects; Psychophysics; Relative processing; Visual illusions; Visual perception

 

Association of Tryptophan Metabolites with Incident Type 2 Diabetes in the PREDIMED Trial: A Case-Cohort Study.

Yu E, Papandreou C, Ruiz-Canela M, Guasch-Ferre M, Clish CB, Dennis C, Liang L, Corella D, Fitó M, Razquin C, Lapetra J, Estruch R, Ros E, Cofán M, Arós F, Toledo E, Serra-Majem L, Sorlí JV, Hu FB, Martinez-Gonzalez MA, Salas-Salvado J.

Clin Chem. 2018 Jun 8. pii: clinchem.2018.288720. doi: 10.1373/clinchem.2018.288720. [Epub ahead of print]

PMID: 29884676

Abstract

BACKGROUND:

Metabolites of the tryptophan-kynurenine pathway (i.e., tryptophan, kynurenine, kynurenic acid, quinolinic acid, 3-hydroxyanthranilic) may be associated with diabetes development. Using a case-cohort design nested in the Prevención con Dieta Mediterránea (PREDIMED) study, we studied the associations of baseline and 1-year changes of these metabolites with incident type 2 diabetes (T2D).

METHODS:

Plasma metabolite concentrations were quantified via LC-MS for n = 641 in a randomly selected subcohort and 251 incident cases diagnosed during 3.8 years of median follow-up. Weighted Cox models adjusted for age, sex, body mass index, and other T2D risk factors were used.

RESULTS:

Contrary to our hypothesis, baseline tryptophan was associated with higher risk of incident T2D (hazard ratio = 1.29; 95% CI, 1.04-1.61 per SD). Positive changes in quinolinic acid from baseline to 1 year were associated with a higher risk of T2D (hazard ratio = 1.39; 95% CI, 1.09-1.77 per SD). Baseline tryptophan and kynurenic acid were directly associated with changes in homeostatic model assessment for insulin resistance (HOMA-IR) from baseline to 1 year. Concurrent changes in kynurenine, quinolinic acid, 3-hydroxyanthranilic acid, and kynurenine/tryptophan ratio were associated with baseline-to-1-year changes in HOMA-IR.

CONCLUSIONS:

Baseline tryptophan and 1-year increases in quinolinic acid were positively associated with incident T2D. Baseline and 1-year changes in tryptophan metabolites predicted changes in HOMA-IR.

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Review and meta-analysis of genetic polymorphisms associated with exceptional human longevity.

Revelas M, Thalamuthu A, Oldmeadow C, Evans TJ, Armstrong NJ, Kwok JB, Brodaty H, Schofield PR, Scott RJ, Sachdev PS, Attia JR, Mather KA.

Mech Ageing Dev. 2018 Jun 8. pii: S0047-6374(18)30078-2. doi: 10.1016/j.mad.2018.06.002. [Epub ahead of print] Review.

PMID: 29890178

Abstract

BACKGROUND:

Many factors contribute to exceptional longevity, with genetics playing a significant role. However, to date, genetic studies examining exceptional longevity have been inconclusive. This comprehensive review seeks to determine the genetic variants associated with exceptional longevity by undertaking meta-analyses.

METHODS:

Meta-analyses of genetic polymorphisms previously associated with exceptional longevity (85+) were undertaken. For each variant, meta-analyses were performed if there were data from at least three independent studies available, including two unpublished additional cohorts.

RESULTS:

Five polymorphisms, ACE rs4340, APOE ε2/3/4, FOXO3A rs2802292, KLOTHO KL-VS and IL6 rs1800795 were significantly associated with exceptional longevity, with the pooled effect sizes (odds ratios) ranging from 0.42 (APOE ε4) to 1.45 (FOXO3A males).

CONCLUSION:

In general, the observed modest effect sizes of the significant variants suggest many genes of small influence play a role in exceptional longevity, which is consistent with results for other polygenic traits. Our results also suggest that genes related to cardiovascular health may be implicated in exceptional longevity. Future studies should examine the roles of gender and ethnicity and carefully consider study design, including the selection of appropriate controls.

KEYWORDS:

ACE; APOE; FOXO3A; centenarians; longevity; meta-analysis

 

Alcohol Intake and Risk of Ischemic and Haemorrhagic Stroke: Results from a Mendelian Randomisation Study.

Christensen AI, Nordestgaard BG, Tolstrup JS.

J Stroke. 2018 May;20(2):218-227. doi: 10.5853/jos.2017.01466. Epub 2018 May 31.

PMID: 29886720

Abstract

BACKGROUND AND PURPOSE:

To test whether alcohol intake, both observational and estimated by genetic instruments, is associated with risk of ischemic and haemorrhagic stroke.

METHODS:

We used data from the Copenhagen City Heart Study 1991 to 1994 and 2001 to 2003, and the Copenhagen General Population Study 2003 to 2012 (n=78,546). As measure of alcohol exposure, self-reported consumption and genetic variation in alcohol metabolizing genes (alcohol dehydrogenase ADH1B and ADH1C) as instrumental variables were used. Stroke diagnoses were obtained from a validated hospital register.

RESULTS:

During follow-up 2,535 cases of ischemic and haemorrhagic stroke occurred. Low and moderate alcohol intake (1 to 20 drinks/week) was associated with reduced risk of stroke. The hazard ratios associated with drinking 1 to 6, 7 to 13, and 14 to 20 drinks/week were 0.84 (95% confidence interval [CI], 0.76 to 0.92), 0.83 (95% CI, 0.73 to 0.94), and 0.84 (95% CI, 0.73 to 0.97), respectively, compared with drinking <1 drink/day. ADH1B and ADH1C genotypes were not associated with risk of stroke. Further analysis to test the included measures revealed that increasing alcohol intake (per 1 drink/day) was positively associated with risk of alcoholic liver cirrhosis, but not associated with risk of stroke, and that increasing blood pressure (per systolic 10 mm Hg) was not associated with risk of alcoholic liver cirrhosis, but positively associated with risk of stroke.

CONCLUSIONS:

Low and moderate self-reported alcohol intake was associated with reduced risk of stroke. The result was not supported by the result from the causal genetic analysis.

KEYWORDS:

Alcohol drinking; Incidence; Mendelian randomisation; Prospective studies; Stroke

 

Gender-specific, Lifestyle-related Factors and 10-year Cardiovascular Disease Risk; the ATTICA and GREECS Cohort Studies.

Matina K, Panagiotakos DB, Chrysohoou C, Georgousopoulou E, Notara V, Tousoulis D, Pitsavos C, The Attica Greecs Studies Investigators.

Curr Vasc Pharmacol. 2018 Jun 8. doi: 10.2174/1570161116666180608121720. [Epub ahead of print]

PMID: 29886832

Abstract

BACKGROUND:

Lifestyle remains a huge driving force of cardiovascular diseases (CVD) onset/progression. Lifestyle-patterns are highly dependent on gender-related attitudes.

OBJECTIVE:

To evaluate the gender-specific association of lifestyle-related factors (adherence to Mediterranean diet (MedDiet), physical activity (PA), smoking) on 10-year first and recurrent CVD events.

METHOD:

Two prospective studies, the ATTICA (2002-2012, n=3,042 subjects free-of-CVD) and GREECS (2004-2014, n=2,172 subjects with acute coronary syndrome (ACS)) were used. Baseline adherence to MedDiet (MedDietScore <27/≥27, range 0-55), PA (sedentary/physically active) and smoking (current/never) were tested against 10-year first (ATTICA) and recurrent (GREECS) CVD events, in men and women.

RESULTS:

The "superiority" of men over women regarding overall CVD events was revealed in both first (ATTICA, 19.7% men vs. 11.7% women, p<0.001) and recurrent CVD events, but less significantly (GREECS, 38.8% men vs. 32.9% women, p=0.016). Gender-stratified analysis revealed that: lower adherence to MedDiet in women (Odds Ratio (OR)=1.22, 95% Confidence Interval (95%CI) 1.03, 1.51) and PA (OR=1.35, 95%CI 1.01, 1.85) and smoking (OR=1.28, 95%CI 1.04, 1.82) in men, were independent predictors of 10-year first CVD event; whereas, adherence to MedDiet (OR=1.28, 95%CI 1.01, 1.59), PA (OR=1.25, 95%CI 1.01, 2.50) and smoking (OR=1.15, 95%CI 1.01, 1.30) in women, yet only adherence to MedDiet (OR=1.27, 95%CI 1.01, 1.35) and PA (OR=1.27, 95%CI 1.02, 1.59) in men, were independent predictors of 10-year CVD recurrent events.

CONCLUSION:

Differences between men and women, in the effect-size measures of lifestyle-related factors, underline different paths for men and women, probably contributing to better designing strategies for primary and secondary CVD prevention.

KEYWORDS:

cardiovascular diseases; gender; lifestyle; primary prevention; secondary prevnetion ; sex

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Glycogen at the Crossroad of Stress Resistance, Energy Maintenance, and Pathophysiology of Aging.

Gusarov I, Nudler E.

Bioessays. 2018 Jun 13:e1800033. doi: 10.1002/bies.201800033. [Epub ahead of print] Review.

PMID: 29897131

Abstract

Glycogen is synthesized and stored to maintain postprandial blood glucose homeostasis and to ensure an uninterrupted energy supply between meals. Although the regulation of glycogen turnover has been well studied, the effects of glycogen on aging and disease development have been largely unexplored. In Caenorhabditis elegans fed a high sugar diet, glycogen potentiates resistance to oxidants, but paradoxically, shortens lifespan. Depletion of glycogen by oxidants or inhibition of glycogen synthesis extends the lifespan of worms by an AMPK-dependent mechanism. Thus, glycogen is not merely an inert storage molecule, but also an active regulator of energy balance and aging. Its depletion by oxidants may be beneficial in the treatment of hyperglycemia and glycogen-related diseases.

KEYWORDS:

AMPK; aging; glucose; glutathione; glycogen; oxidative stress

 

Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts.

Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators.

N Engl J Med. 2018 Jun 13. doi: 10.1056/NEJMoa1800389. [Epub ahead of print]

PMID: 29897866

Abstract

Background Observational cohort studies and a secondary prevention trial have shown inverse associations between adherence to the Mediterranean diet and cardiovascular risk. Methods In a multicenter trial in Spain, we assigned 7447 participants (55 to 80 years of age, 57% women) who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was a major cardiovascular event (myocardial infarction, stroke, or death from cardiovascular causes). After a median follow-up of 4.8 years, the trial was stopped on the basis of a prespecified interim analysis. In 2013, we reported the results for the primary end point in the Journal. We subsequently identified protocol deviations, including enrollment of household members without randomization, assignment to a study group without randomization of some participants at 1 of 11 study sites, and apparent inconsistent use of randomization tables at another site. We have withdrawn our previously published report and now report revised effect estimates based on analyses that do not rely exclusively on the assumption that all the participants were randomly assigned. Results A primary end-point event occurred in 288 participants; there were 96 events in the group assigned to a Mediterranean diet with extra-virgin olive oil (3.8%), 83 in the group assigned to a Mediterranean diet with nuts (3.4%), and 109 in the control group (4.4%). In the intention-to-treat analysis including all the participants and adjusting for baseline characteristics and propensity scores, the hazard ratio was 0.69 (95% confidence interval [CI], 0.53 to 0.91) for a Mediterranean diet with extra-virgin olive oil and 0.72 (95% CI, 0.54 to 0.95) for a Mediterranean diet with nuts, as compared with the control diet. Results were similar after the omission of 1588 participants whose study-group assignments were known or suspected to have departed from the protocol. Conclusions In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

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Dietary Intake of Energy and Nutrients from Breakfast and Risk of Stroke in The Japanese Population: The Circulatory Risk in Communities Study (CIRCS).

Okada C, Imano H, Yamagishi K, Cui R, Umesawa M, Maruyama K, Muraki I, Hayama-Terada M, Shimizu Y, Sankai T, Okada T, Kiyama M, Kitamura A, Iso H; CIRCS Investigators.

J Atheroscler Thromb. 2018 Jun 13. doi: 10.5551/jat.44438. [Epub ahead of print]

PMID: 29899172

https://sci-hub.tw/https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_44438/_article

Abstract

AIMS:

The frequency of breakfast intake has been reported to be inversely associated with the risk of cardiovascular events; however, it is uncertain what the impact of the energy and nutrient intakes from breakfast are. We assessed the association between these intakes from breakfast and the risk of stroke prospectively.

METHODS:

In a baseline survey of four Japanese communities between 1981 and 1990, we enrolled 3 248 residents (1 662 men and 1 586 women) aged 40-59 years who were free from stroke and heart disease and who responded to the 24-hour dietary recall survey. We assessed the dietary intake at breakfast, lunch, dinner, and other times separately.

RESULTS:

During the median 25-year follow-up, 230 individuals (147 men and 83 women) developed stroke. After adjustment for age, community, other dietary intakes, and lifestyle and physiological factors, the multivariable-adjusted hazard ratios (95% confidence intervals) of intracerebral hemorrhage for the highest versus lowest quartiles of energy intake from breakfast were 0.38 (0.15-0.99) in men and 1.36 (0.36-5.10) in women. For the major nutrients, a higher saturated or monounsaturated fat intake at breakfast was associated with a reduced risk of intracerebral hemorrhage in men, and remained statistically significant after further adjustment for intake of other major nutrients from breakfast.

CONCLUSIONS:

A higher intake of energy from breakfast, primarily saturated or monounsaturated fat, was associated with a reduced risk of intracerebral hemorrhage in Japanese men.

KEYWORDS:

Breakfast; Energy; Macronutrients; Prospective study; Stroke

 

Muscle Protein Anabolic Resistance to Essential Amino Acids Does Not Occur in Healthy Older Adults Before or After Resistance Exercise Training.

Moro T, Brightwell CR, Deer RR, Graber TG, Galvan E, Fry CS, Volpi E, Rasmussen BB.

J Nutr. 2018 Jun 1;148(6):900-909. doi: 10.1093/jn/nxy064.

PMID: 29796648

Abstract

BACKGROUND:

The muscle protein anabolic response to contraction and feeding may be blunted in older adults. Acute bouts of exercise can improve the ability of amino acids to stimulate muscle protein synthesis (MPS) by activating mechanistic target of rapamycin complex 1 (mTORC1) signaling, but it is not known whether exercise training may improve muscle sensitivity to amino acid availability.

OBJECTIVE:

The aim of this study was to determine if muscle protein anabolism is resistant to essential amino acids (EAAs) and whether resistance exercise training (RET) improves muscle sensitivity to EAA in healthy older adults.

METHODS:

In a longitudinal study, 19 healthy older adults [mean ± SD age: 71 ± 4 y body mass index (kg/m2): 28 ± 3] were trained for 12 wk with a whole-body program of progressive RET (60-75% 1-repetition maximum). Body composition, strength, and metabolic health were measured pre- and posttraining. We also performed stable isotope infusion experiments with muscle biopsies pre- and posttraining to measure MPS and markers of amino acid sensing in the basal state and in response to 6.8 g of EAA ingestion.

RESULTS:

RET increased muscle strength by 16%, lean mass by 2%, and muscle cross-sectional area by 27% in healthy older adults (P < 0.05). MPS and mTORC1 signaling (i.e., phosphorylation status of protein kinase B, 4E binding protein 1, 70-kDa S6 protein kinase, and ribosomal protein S6) increased after EAA ingestion (P < 0.05) pre- and posttraining. RET increased basal MPS by 36% (P < 0.05); however, RET did not affect the response of MPS and mTORC1 signaling to EAA ingestion.

CONCLUSION:

RET increases strength and basal MPS, promoting hypertrophy in healthy older adults. In these subjects, a small dose of EAAs stimulates muscle mTORC1 signaling and MPS, and this response to EAAs does not improve after RET. Our data indicate that anabolic resistance to amino acids may not be a problem in healthy older adults.

 

Risk Factors for Orthostatic Hypotension: Differences Between Elderly Men and Women.

Méndez AS, Melgarejo JD, Mena LJ, Chávez CA, González AC, Boggia J, Terwilliger JD, Lee JH, Maestre GE.

Am J Hypertens. 2018 Jun 11;31(7):797-803. doi: 10.1093/ajh/hpy050.

PMID: 29617895

Abstract

BACKGROUND:

Orthostatic hypotension (OH) occurs when mechanisms regulating blood pressure (BP) levels after standing-up are altered. It is unclear how prevalence and risk factors for OH are different between sexes. We aimed to investigate sex differences in prevalence and risk factors for OH elderly individuals.

METHODS:

We included 882 participants from Maracaibo Aging Study. OH was a sustained reduction of ≥20 mm Hg in systolic BP, ≥10 mm Hg in diastolic BP, or both, after 3 minutes of changing positions from supine to standing. Multivariable logistic regression models were used to examine the relationships among risk factors for OH in men and women considering interaction sex-term and stratified by sex.

RESULTS:

The mean age was 66.7 ± 8.5 years, being similar by sex. Women and men 55-74 years had similar prevalence of OH+ (18.5% vs. 20.9%, respectively). After 75 years, the proportion of women with OH+ was lower than men (11% vs. 30%, respectively). Hypertension, specifically systolic BP ≥140 mm Hg, and high pulse pressure (PP) were related with OH+ accounted by interaction sex-term, while diastolic BP ≥90 mm Hg, antihypertensive treatment, body mass index (BMI), diabetes mellitus and age were not. Systolic BP ≥140 mm Hg increases the risk of OH only among women, while BMI showed an inverse association in both sexes.

CONCLUSIONS:

Although the prevalence of OH is similar in both sexes, there are different risk factors associated by sex. Systolic BP ≥140 mm Hg was associated with increased risk of OH only with women while BMI was a protective factor for OH in men and women.

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Body-mass index, blood pressure, and cause-specific mortality in India: a prospective cohort study of 500 810 adults.

Gajalakshmi V, Lacey B, Kanimozhi V, Sherliker P, Peto R, Lewington S.

Lancet Glob Health. 2018 Jul;6(7):e787-e794. doi: 10.1016/S2214-109X(18)30267-5.

PMID: 29903379

Abstract

BACKGROUND:

The association between cause-specific mortality and body-mass index (BMI) has been studied mainly in high-income countries. We investigated the relations between BMI, systolic blood pressure, and mortality in India.

METHODS:

Men and women aged 35 years or older were recruited into a prospective study from the general population in Chennai, India between Jan 1, 1998, and Dec 31, 2001. Participants were interviewed (data collected included age, sex, education, socioeconomic status, medical history, tobacco smoking, and alcohol intake) and measured (height, weight, and blood pressure). Deaths were identified by linkage to Chennai city mortality records and through active surveillance by household visits from trained graduate non-medical fieldworkers. After the baseline survey, households were visited once in 2002-05, then biennially until 2015. During these repeat visits, structured narratives of any deaths that took place before March 31, 2015, were recorded for physician coding. During 2013-14, a random sample of participants was also resurveyed as per baseline to assess long-term variability in systolic blood pressure and BMI. Cox regression (standardised for tobacco, alcohol, and social factors) was used to relate mortality rate ratios (RRs) at ages 35-69 years to systolic blood pressure, BMI, or BMI adjusted for usual systolic blood pressure.

FINDINGS:

500 810 participants were recruited. After exclusion of those with chronic disease or incomplete data, 414 746 participants aged 35-69 years (mean 46 [sD 9]; 45% women) remained. At recruitment, mean systolic blood pressure was 127 mm Hg (SD 15), and mean BMI was 23·2 kg/m2 (SD 3·8). Correlations of resurvey and baseline measurements were 0·50 for systolic blood pressure and 0·88 for BMI. Low BMI was strongly associated with poverty, tobacco, and alcohol. Of the 29 519 deaths at ages 35-69 years, the cause was vascular for 14 935 deaths (12 504 cardiac, 1881 stroke, and 550 other). Vascular mortality was strongly associated with systolic blood pressure: RRs per 20 mm Hg increase in usual systolic blood pressure were 2·45 (95% CI 2·16-2·78) for stroke mortality, 1·74 (1·64-1·84) for cardiac mortality, and 1·84 (1·75-1·94) for all vascular mortality. Although BMI strongly affected systolic blood pressure (an increase of about 1 mm Hg per kg/m2) and diabetes prevalence, BMI was little related to cardiac or stroke mortality, with only small excesses even for grade 1 obesity (ie, BMIs of 30·0-35·0 kg/m2). After additional adjustment for usual systolic blood pressure, BMI was inversely related to cardiac and stroke mortality throughout the range 15·0-30·0 kg/m2: when underweight participants (ie, BMI 15·0-18·5 kg/m2) were compared with overweight participants (ie, BMI 25·0-30·0 kg/m2), the blood-pressure-adjusted RR was 1·28 (95% CI 1·20-1·38) for cardiac mortality and 1·46 (1·22-1·73) for stroke mortality.

INTERPRETATION:

In this South Asian population, BMI was little associated with vascular mortality, even though increased BMI is associated with increased systolic blood pressure, which in turn is associated with increased vascular mortality. Hence, some close correlates of below-average BMI must have important adverse effects, which could be of relevance in all populations.

 

Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort.

Schnabel L, Buscail C, Sabate JM, Bouchoucha M, Kesse-Guyot E, Allès B, Touvier M, Monteiro CA, Hercberg S, Benamouzig R, Julia C.

Am J Gastroenterol. 2018 Jun 15. doi: 10.1038/s41395-018-0137-1. [Epub ahead of print]

PMID: 29904158

https://sci-hub.tw/

Abstract

OBJECTIVES:

Ultra-processed foods (UPF) consumption has increased over the last decades and is raising concerns about potential adverse health effects. Our objective was to assess the association between UPF consumption and four functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional constipation (FC), functional diarrhea (FDh), and functional dyspepsia (FDy), in a large sample of French adults.

METHODS:

We analyzed dietary data of 33,343 participants from the web-based NutriNet-Santé cohort, who completed at least three 24 h food records, prior to a Rome III self-administered questionnaire. Proportion (in weight) of UPF in the diet (UPFp) was computed for each subject. The association between UPFp quartiles and FGIDs was estimated by multivariable logistic regression.

RESULTS:

Participants included in the analysis were mainly women (76.4%), and the mean age was 50.4 (SD = 14.0) years. UPF accounted for 16.0% of food consumed in weight, corresponding to 33.0% of total energy intake. UPF consumption was associated with younger age, living alone, lower incomes, higher BMI, and lower physical activity level (all p < 0.0001). A total of 3516 participants reported IBS (10.5%), 1785 FC (5.4%), 1303 FDy (3.9%), and 396 FDh (1.1%). After adjusting for confounding factors, an increase in UPFp was associated with a higher risk of IBS (aOR Q4 vs. Q1 [95% CI]: 1.25 [1.12-1.39], p-trend < 0.0001).

CONCLUSIONS:

This study suggests an association between UPF and IBS. Further longitudinal studies are needed to confirm those results and understand the relative impact of the nutritional composition and specific characteristics of UPF in this relationship.

 

A Prospective Study of Dietary Polyunsaturated Fatty Acids Intake and Lung Cancer Risk.

Luu HN, Cai H, Murff HJ, Xiang YB, Cai Q, Li H, Gao J, Yang G, Lan Q, Gao YT, Zheng W, Shu XO.

Int J Cancer. 2018 Jun 15. doi: 10.1002/ijc.31608. [Epub ahead of print]

PMID: 29905376

http://sci-hub.tw/https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.31608

Abstract

Animal studies have shown that polyunsaturated fatty acids (PUFAs) have antineoplastic and anti-inflammatory properties. Results from epidemiologic studies on specific types of PUFAs for lung cancer risk, however, are inconclusive. We prospectively evaluated the association of specific types of dietary PUFA intakes and lung cancer risk in two population-based cohort studies, the Shanghai Women's Health Study (SWHS) and Shanghai Men's Health Study (SMHS) with a total of 121,970 study participants (i.e., 65,076 women and 56,894 men). Dietary fatty acid intakes were derived from data collected at the baseline using validated food frequency questionnaires (FFQs). Cox proportional hazards model was performed to assess the association between PUFAs and lung cancer risk. Total, saturated and monounsaturated fatty acid intakes were not significantly associated with lung cancer risk. Total PUFAs intake was inversely associated with lung cancer risk [hrs and respective 95% CIs for quintiles 2 to 5 versus quintile 1: 0.84 (0.71-0.98), 0.97 (0.83-1.13), 0.86 (0.74-1.01) and 0.85 (0.73-1.00), Ptrend =0.11]. However, DHA intake was positively associated with lung cancer risk [hrs and 95% CIs: 1.01 (0.86-1.19), 1.20 (1.03-1.41), 1.21 (1.03-1.42) and 1.24 (1.05-1.47), Ptrend =0.001]. The ratio of n-6 PUFAs to n-3 PUFAs (i.e., 7:1) was inversely associated with lung cancer risk, particularly among never-smokers and adenocarcinoma patients. Total PUFAs and the ratio between n-6 PUFAs and n-3 PUFAs were inversely associated with lung cancer risk. Our current study highlights an important public health impact of PUFA intakes toward intervention/prevention programs of lung cancer.

KEYWORDS:

Polyunsaturated fatty acids; lung cancer risk

 

[Why not adjust for alcohol intake, exercise, parity, etcetera?]

Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20 ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort.

McDonnell SL, Baggerly CA, French CB, Baggerly LL, Garland CF, Gorham ED, Hollis BW, Trump DL, Lappe JM.

PLoS One. 2018 Jun 15;13(6):e0199265. doi: 10.1371/journal.pone.0199265. eCollection 2018.

PMID: 29906273

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0199265&type=printable

Abstract

BACKGROUND:

While numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and lower breast cancer risk, few have assessed this association for concentrations >40 ng/ml.

OBJECTIVE:

To investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older.

METHODS:

Analyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements.

RESULTS:

Within the pooled cohort (N = 5038), 77 women were diagnosed with breast cancer (age-adjusted incidence: 512 cases per 100,000 person-years). Results were similar for the three analyses. First, comparing incidence rates, there was an 82% lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/ml (Rate Ratio = 0.18, P = 0.006). Second, Kaplan-Meier curves for concentrations of <20, 20-39, 40-59 and ≥60 ng/ml were significantly different (P = 0.02), with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3%) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8%). The proportion with breast cancer was 78% lower for ≥60 vs <20 ng/ml (P = 0.02). Third, multivariate Cox regression revealed that women with 25(OH)D concentrations ≥60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml (HR = 0.20, P = 0.03), adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin.

CONCLUSIONS:

Higher 25(OH)D concentrations were associated with a dose-response decrease in breast cancer risk with concentrations ≥60 ng/ml being most protective.

 

Effects of Coffee Intake on Incident Chronic Kidney Disease: Community-Based Prospective Cohort Study.

Jhee JH, Nam KH, An SY, Cha MU, Lee M, Park S, Kim H, Yun HR, Kee YK, Park JT, Chang TI, Kang EW, Yoo TH, Kang SW, Han SH.

Am J Med. 2018 Jun 12. pii: S0002-9343(18)30510-2. doi: 10.1016/j.amjmed.2018.05.021. [Epub ahead of print]

PMID: 29906428

Abstract

BACKGROUND:

Drinking coffee can raise public health problems, but the association between coffee and kidney disease is unknown. We studied whether coffee intake can affect the development of chronic kidney disease in the general population.

METHODS:

We analyzed 8717 subjects with normal renal function recruited from the KoGES cohort. Based on food frequency questionnaire, coffee consumption was categorized into five groups: 0/week, <1 cup/week, 1-6 cups/week, 1 cup/day, and ≥2 cups/day. The primary outcome was incident chronic kidney disease defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2.

RESULTS:

The mean age of study subjects was 52.0 (8.8) years and 47.8% were male. Among the subjects, 52.8% were daily coffee consumers. During a mean follow-up of 11.3 [5.9-11.5] years, 9.5% of participants developed chronic kidney disease. The incident chronic kidney disease occurred less in daily coffee consumers. Unadjusted HRs was significantly lower in daily coffee consumers. In multivariable Cox model even after adjustment of blood pressure, hypertension, cardiovascular disease, diabetes, and amount of daily intake for caffeine-containing foods such as tea and chocolate, coffee consumers with 1 cup/day (HR, 0.76; 95% CI, 0.63-0.92) and ≥2 cups/day (HR, 0.80; 95% CI, 0.65-0.98) were associated with a lower risk of chronic kidney disease development than non-drinkers. Time-averaged and time-varying Cox models yielded similar results. The rates of decline in eGFR were lower in daily coffee consumers.

CONCLUSIONS:

Our findings suggest that daily coffee intake is associated with decreased risk of the development of CKD.

KEYWORDS:

Caffeine; Chronic kidney disease; Coffee; Daily coffee intake

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[in human equivalents, it is a lot of melatonin given the animals.]

Melatonin induces mechanisms of brain resilience against neurodegeneration.

Corpas R, Griñán-Ferré C, Palomera-Ávalos V, Porquet D, de Frutos PG, Franciscato Cozzolino SM, Rodríguez-Farré E, Pallàs M, Sanfeliu C, Cardoso BR.

J Pineal Res. 2018 Jun 15:e12515. doi: 10.1111/jpi.12515. [Epub ahead of print]

PMID: 29907977

Abstract

Melatonin is an endogenous pleiotropic molecule which orchestrates regulatory functions and protective capacity against age-related ailments. The increase in circulating levels of melatonin through dietary supplements intensifies its health benefits. Investigations in animal models have shown that melatonin protects against Alzheimer's disease (AD)-like pathology, although clinical studies have not been conclusive. We hypothesized that melatonin induces changes in the brain that prevent or attenuate AD by increasing resilience. Therefore, we treated healthy non-transgenic (NoTg) and AD transgenic (3xTg-AD) 6-month old mice with a daily dose of 10 mg/kg of melatonin until 12 months of age. As expected, melatonin reversed cognitive impairment and dementia-associated behaviors of anxiety and apathy, and reduced amyloid and tau burden in 3xTg-AD mice. Remarkably, melatonin induced cognitive enhancement and higher wellness level-related behavior in NoTg mice. At the mechanism level, NF-κB and pro-inflammatory cytokine expression was decreased in both NoTg and 3xTg-AD mice. The SIRT1 pathway of longevity and neuroprotection was also activated in both mouse strains after melatonin dosing. Furthermore, we explored new mechanisms and pathways not previously associated with melatonin treatment such as the ubiquitin-proteasome proteolytic system and the recently proposed neuroprotective Gas6/TAM pathway. The upregulation of proteasome activity and the modulation of Gas6 and its receptors by melatonin was similarly displayed by both NoTg and 3xTg-AD mice. Therefore, these results confirm the potential of melatonin treatment against AD pathology, by way of opening new pathways in its mechanisms of action, and demonstrating that melatonin induces cognitive enhancement and brain resilience against neurodegenerative processes. This article is protected by copyright. All rights reserved.

KEYWORDS:

Gas6; Melatonin; SIRT1; inflammation; neuroprotection; proteasome; resilience

 

Dietary sodium, sodium-to-potassium ratio, and risk of stroke: A systematic review and nonlinear dose-response meta-analysis.

Jayedi A, Ghomashi F, Zargar MS, Shab-Bidar S.

Clin Nutr. 2018 Jun 1. pii: S0261-5614(18)30202-4. doi: 10.1016/j.clnu.2018.05.017. [Epub ahead of print]

PMID: 29907351

Abstract

BACKGROUND & AIMS:

The association of high sodium intake with risk of stroke has been accepted. But considering the proposed J/U-shaped association between sodium intake and risk of all-cause mortality, the shape of the dose-response relationship has not been determined yet. This study aimed to test the dose-response association of dietary sodium and sodium-to-potassium ratio with risk of stroke in adults aged 18 years or older.

METHODS:

We performed a systematic search using PubMed and Scopus, from database inception up to October 2017. Prospective and retrospective observational studies reporting risk estimates of stroke for three or more quantitative categories of dietary sodium or sodium-to-potassium ratio were included. Studies that reported results as continuous were also included. Two independent authors extracted the information and assessed the quality of included studies. Pooled relative risk (RR) was calculated using a random-effects model. Publication bias was tested. Sensitivity and subgroup analyses were done.

RESULTS:

Of initial 20,412 studies identified, 14 prospective cohort studies, one case-cohort study, and one case-control study (total n = 261,732) with 10,150 cases of stroke were included. The Pooled RRs of stroke were 1.06 (95%CI: 1.02, 1.10; I2 = 60%, n = 14 studies) for a 1 gr/d increment in dietary sodium intake, and 1.22 (95%CI: 1.04, 1.41; I2 = 60%, n = 5 studies) for a one-unit increment in dietary sodium-to-potassium ratio (mmol/mmol). The risk of stroke increased linearly with increasing dietary sodium intake, and also along with the increase in dietary sodium-to-potassium ratio. No evidence of a J/U-shaped association was found in the analyses of total stroke, stroke incidence, and stroke mortality. High sodium intake was associated with a somewhat worse prognosis among Asian countries as compared to westerns.

CONCLUSION:

Higher sodium intake and higher dietary sodium-to-potassium ratio were associated with a higher risk of stroke. Reducing dietary sodium-to-potassium ratio can be considered as a supplementary approach in parallel with the decrease in sodium intake in order to decrease stroke risk. The interpretation of the results is limited by observational nature of studies examined.

KEYWORDS:

Cardiovascular disease; Dietary sodium; Hypertension; Meta-analysis; Stroke

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Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK Biobank participants.

Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS.

Lancet Public Health. 2018 Jun 13. pii: S2468-2667(18)30091-4. doi: 10.1016/S2468-2667(18)30091-4. [Epub ahead of print]

PMID: 29908859

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30091-4/fulltext

https://www.thelancet.com/pdfs/journals/lanpub/PIIS2468-2667(18)30091-4.pdf

Abstract

BACKGROUND:

Frailty is associated with older age and multimorbidity (two or more long-term conditions); however, little is known about its prevalence or effects on mortality in younger populations. This paper aims to examine the association between frailty, multimorbidity, specific long-term conditions, and mortality in a middle-aged and older aged population.

METHODS:

Data were sourced from the UK Biobank. Frailty phenotype was based on five criteria (weight loss, exhaustion, grip strength, low physical activity, slow walking pace). Participants were deemed frail if they met at least three criteria, pre-frail if they fulfilled one or two criteria, and not frail if no criteria were met. Sociodemographic characteristics and long-term conditions were examined. The outcome was all-cause mortality, which was measured at a median of 7 years follow-up. Multinomial logistic regression compared sociodemographic characteristics and long-term conditions of frail or pre-frail participants with non-frail participants. Cox proportional hazards models examined associations between frailty or pre-frailty and mortality. Results were stratified by age group (37-45, 45-55, 55-65, 65-73 years) and sex, and were adjusted for multimorbidity count, socioeconomic status, body-mass index, smoking status, and alcohol use.

FINDINGS:

493 737 participants aged 37-73 years were included in the study, of whom 16 538 (3%) were considered frail, 185 360 (38%) pre-frail, and 291 839 (59%) not frail. Frailty was significantly associated with multimorbidity (prevalence 18% [4435/25 338] in those with four or more long-term conditions; odds ratio [OR] 27·1, 95% CI 25·3-29·1) socioeconomic deprivation, smoking, obesity, and infrequent alcohol consumption. The top five long-term conditions associated with frailty were multiple sclerosis (OR 15·3; 99·75% CI 12·8-18·2); chronic fatigue syndrome (12·9; 11·1-15·0); chronic obstructive pulmonary disease (5·6; 5·2-6·1); connective tissue disease (5·4; 5·0-5·8); and diabetes (5·0; 4·7-5·2). Pre-frailty and frailty were significantly associated with mortality for all age strata in men and women (except in women aged 37-45 years) after adjustment for confounders.

INTERPRETATION:

Efforts to identify, manage, and prevent frailty should include middle-aged individuals with multimorbidity, in whom frailty is significantly associated with mortality, even after adjustment for number of long-term conditions, sociodemographics, and lifestyle. Research, clinical guidelines, and health-care services must shift focus from single conditions to the requirements of increasingly complex patient populations.

 

[The table did not show that honey was better for triglycerides.]

The effect of honey consumption compared with sucrose on lipid profile in young healthy subjects (randomized clinical trial).

Rasad H, Entezari MH, Ghadiri E, Mahaki B, Pahlavani N.

Clin Nutr ESPEN. 2018 Aug;26:8-12. doi: 10.1016/j.clnesp.2018.04.016. Epub 2018 May 19.

PMID: 29908688

https://sci-hub.tw/

Abstract

BACKGROUND AND AIMS:

Several studies have demonstrated that honey consumption has beneficial effects on cardiovascular disease indicators. The current study aimed to investigate the effect of honey consumption compared with sucrose on lipid profile among young healthy subjects.

METHODS:

Sixty healthy subjects, aged 18-30 years, were randomly recruited into this double blind randomized trial and assigned into two groups: honey (received 70 g honey per day) and sucrose (received 70 g sucrose per day) groups. Total cholesterol, TG, LDL and HDL were measured in the control and intervention groups at the beginning and end of study.

RESULTS:

In this trial, the baseline FBS, SBP and DBP were not different between honey and sucrose groups (P > 0.3). We found evidence indicating consumption of honey can decrease total cholesterol, TG and LDL and increase HDL in healthy young subjects, but intake of sucrose increase total cholesterol, TG and LDL and decreased HDL. In all of these analyses, confounding variable including age, physical activity and some nutrient intake were adjusted.

CONCLUSIONS:

Honey consumption can improve the lipid profile such as; total cholesterol, TG and LDL and increase HDL, but consumption of sucrose increases total cholesterol, TG and LDL and decreases HDL. Further clinical trial studies are required to confirm our findings.

KEYWORDS:

High density lipoprotein (HDL); Honey; Low density lipoprotein (LDL); Sucrose; Total cholesterol; Triacylglycerol (TG)

 

Processed red meat intake and risk of COPD: A systematic review and dose-response meta-analysis of prospective cohort studies.

Salari-Moghaddam A, Milajerdi A, Larijani B, Esmaillzadeh A.

Clin Nutr. 2018 Jun 1. pii: S0261-5614(18)30205-X. doi: 10.1016/j.clnu.2018.05.020. [Epub ahead of print]

PMID: 29909249

Abstract

BACKGROUND & AIMS:

No earlier study has summarized findings from previous publications on processed red meat intake and risk of Chronic Obstructive Pulmonary Disease (COPD). This systematic review and meta-analysis was conducted to examine the association between processed red meat intake and COPD risk.

METHODS:

We searched in PubMed/Medline, ISI Web of Knowledge, Scopus, EMBASE and Google Scholar up to April 2018 to identify relevant studies. Prospective cohort studies that considered processed red meat as the exposure variable and COPD as the main outcome variable or as one of the outcomes were included in the systematic review. Publications in which hazard ratios (HRs) were reported as effect size were included in the meta-analysis. Finally, five cohort studies were considered in this systematic review and meta-analysis.

RESULTS:

In total, 289,952 participants, including 8338 subjects with COPD, aged ≥27 years were included in the meta-analysis. These studies were from Sweden and the US. Linear dose response meta-analysis revealed that each 50 gr/week increase in processed red meat intake was associated with 8% higher risk of COPD (HR: 1.08; 95% CI: 1.03, 1.13). There was an evidence of non-linear association between processed red meat intake and risk of COPD (P < 0.001).

CONCLUSIONS:

In this systematic review and meta-analysis, we found a significant positive association between processed red meat intake and risk of COPD.

KEYWORDS:

COPD; Chronic obstructive pulmonary disease; Diet; Processed red meat

 

Intermittent mTOR Inhibition Reverses Kidney Aging in Old Rats.

Di Francesco A, Diaz-Ruiz A, de Cabo R, Bernier M.

J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):843-844. doi: 10.1093/gerona/gly023. No abstract available.

PMID: 29420687

https://academic.oup.com/biomedgerontology/article/73/7/843/4838359

Summary

Short-term administration of the rapamycin analogue RAD001 (everolimus), already approved for clinical use for different human disorders, has been found to counter-regulate age-related transcriptomic changes and kidney pathology in rats. The study offers a step forward in establishing a safer rapalog dosing regimen for the treatment of age-related diseases.

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

Short-term Low-Dose mTORC1 Inhibition in Aged Rats Counter-Regulates Age-Related Gene Changes and Blocks Age-Related Kidney Pathology.

Shavlakadze T, Zhu J, Wang S, Zhou W, Morin B, Egerman MA, Fan L, Wang Y, Iartchouk O, Meyer A, Valdez RA, Mannick JB, Klickstein LB, Glass DJ.

J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):845-852. doi: 10.1093/gerona/glx249.

PMID: 29304191

https://watermark.silverchair.com/glx249.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAbwwggG4BgkqhkiG9w0BBwagggGpMIIBpQIBADCCAZ4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMdY71RWtj43JxQoZ4AgEQgIIBb-2rrN9ImoKlZB5Ucdrfnuzl42nQQh8j77OPdhPU7Y8Rgmbm2p96mtB0nP_ECN3yyCn6bi_DsxeJzW5Z9pGhCHo06SRHBz1_PHIxJNtQwXHhxeaQRG7GcjyVqiVnb-PcX4JQqo7xqxO5gGvFFY0-14HdCewBsXrGRQVynwDBPRAjnrHzKXpzdO4IofitHWVOaT8tWaV7QwKWR4XV1LYugFSuSUd8sG-27qYFxtrTJaqsUuHmls1OfwyyvGo9Lrc8EsO6EZNri6Z_5RgeGfbKltjuUssqTRCRE6yBE3X0CRpF4O4Hol7INa6hkGlpbLThzv3wg7NLxWse5iMfwSJHUks9R5AWQuYx4z0Bwz338xVdU8136LMCVMtn-ypQ-xgKxqINtC4DnV1UJaEdCMP6AoOrAxGN44RMwC7vAUP82A-p3Xh1bKj-OFlLwXqTaD0vS4A5KpH786lPNUJzGudPxW1GxrMk-y5qvgs6Lo6BEJY

Abstract

Rapalogs, inhibitors of mTORC1 (mammalian target of rapamycin complex 1), increase life span and delay age-related phenotypes in many species. However, the molecular mechanisms have not been fully elucidated. We determined gene expression changes comparing 6- and 24-month-old rats in the kidney, liver, and skeletal muscle, and asked which of these changes were counter-regulated by a clinically-translatable (short-term and low-concentration) treatment, with a rapalog (RAD001). Surprisingly, RAD001 had a more pronounced effect on the kidney under this regimen in comparison to the liver or skeletal muscle. Histologic evaluation of kidneys revealed that the severity of chronic progressive nephropathy lesions was lower in kidneys from 24-month-old rats treated with RAD001 compared with vehicle. In addition to other gene expression changes, c-Myc, which has been shown to regulate aging, was induced by aging in the kidney and counter-regulated by RAD001. RAD001 caused a decrease in c-Myc protein, which could be rescued by a proteasome inhibitor. These findings point to settings for use of mTORC1 inhibitors to treat age-related disorders, and highlight c-Myc regulation as one of the potential mechanisms by which mTORC1 inhibition is perturbing age-related phenotypes.

"This work was supported by Novartis."

 

Improvements in Behavior and Immune Function and Increased Life Span of Old Mice Cohabiting With Adult Animals.

Garrido A, Cruces J, Ceprián N, De la Fuente M.

J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):873-881. doi: 10.1093/gerona/gly043.

PMID: 29506242

https://sci-hub.tw/

Abstract

The social environment can affect the regulatory systems, and cohabitation with sick subjects is a negative factor for the nervous and immune systems, compromising the life span. Nevertheless, the possible beneficial effects of a positive social environment on nervous and immune functions and longevity have not yet been studied. The aim of this study was to analyze several behavioral and immune function parameters and life span in old mice after their cohabitation with adult animals. Old and adult ICR-CD1 female mice were divided into three experimental groups: adult controls, old controls, and a social environment experimental group. The latter contained two old mice with five adult mice. After 2 months in these conditions, mice were submitted to a behavioral battery of tests to analyze their sensorimotor abilities, anxiety-like behaviors, and exploratory capacities. Peritoneal leukocytes were then collected, and several immune functions as well as oxidative and inflammatory stress parameters were assessed. The animals were maintained in the same conditions until natural death occurred. The results showed that old animals, after cohabitation with adult mice, presented an improvement of behavioral capacities, immune functions, and a lower oxidative and inflammatory stress. Consequently, they exhibited a higher life span.

 

Low Alanine Aminotransferase Levels in the Elderly Population: Frailty, Disability, Sarcopenia, and Reduced Survival.

Vespasiani-Gentilucci U, De Vincentis A, Ferrucci L, Bandinelli S, Antonelli Incalzi R, Picardi A.

J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):925-930. doi: 10.1093/gerona/glx126.

PMID: 28633440

https://sci-hub.tw/

Abstract

BACKGROUND:

Although low alanine aminotransferase (ALT) levels have been associated with poor outcomes in the elderly population, the determinants subtending this association have been poorly explored. To gain insight into this topic, we analyzed data from a prospective population-based database (InCHIANTI study) in which frailty, disability, sarcopenia, and pyridoxine levels were systematically assessed.

METHODS:

Data are from 765 participants aged more than 65 years (mean age 75.3 years, women 61.8%), without chronic liver disease, malignancies, or alcohol abuse. Frailty was defined according to Fried criteria, sarcopenia through peripheral Quantitative-Computed-Tomography (lowest gender-specific tertile of the residuals of a linear regression of muscle mass from height and fat mass), and disability as self-reported need for help in at least one basic daily living activity. Associations of ALT with overall and cardiovascular mortality were assessed by Cox-models with time-dependent covariates.

RESULTS:

ALT activity was inversely associated with frailty, sarcopenia, disability, and pyridoxine deficiency; however, higher ALT was confirmed to be protective with respect of overall and cardiovascular mortality even in multiple-adjusted models including all these covariates (overall: hazard ratio {HR} 0.98 [0.96-1], p = .02; cardiovascular: 0.94 [0.9-0.98], p < .01). The association between ALT activity and mortality was nonlinear (J-shaped), and subjects in the lower quintiles of ALT levels showed a sharply increased overall and cardiovascular mortality.

CONCLUSIONS:

These results suggest that reduced ALT levels in older individuals can be considered as a marker of frailty, disability, and sarcopenia, and as an independent predictor of adverse outcomes. The possible relationship between reduced ALT and impaired hepatic metabolic functions should be explored.

 

Trajectories of IGF-I Predict Mortality in Older Adults: The Cardiovascular Health Study.

Sanders JL, Guo W, O'Meara ES, Kaplan RC, Pollak MN, Bartz TM, Newman AB, Fried LP, Cappola AR.

J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):953-959. doi: 10.1093/gerona/glx143.

PMID: 28977343

Abstract

BACKGROUND:

Disruption of insulin-like growth factor-I (IGF-I) increases health and life span in animal models, though this is unconfirmed in humans. If IGF-I stability indicates homeostasis, the absolute level of IGF-I may be less clinically relevant than maintaining an IGF-I setpoint.

METHODS:

Participants were 945 U.S. community-dwelling individuals aged ≥65 years enrolled in the Cardiovascular Health Study with IGF-I levels at 3-6 timepoints. We examined the association of baseline IGF-I level, trajectory slope, and variability around the trajectory with mortality.

RESULTS:

There were 633 deaths over median 11.3 years of follow-up. Lower IGF-I levels, declining or increasing slope, and increasing variability were each individually associated with higher mortality (all p < .001). In an adjusted model including all three trajectory parameters, baseline IGF-I levels <70 ng/mL (hazard ratio {HR} 1.58, 95% CI 1.28-1.96 relative to IGF-I levels of 170 ng/mL), steep declines and steep increases in trajectory slope (HR 2.22, 1.30-3.80 for a 15% decline; HR 1.40, 1.07-1.84 for a 10% decline; HR 1.80, 1.12-2.89 for a 15% increase; HR 1.31, 1.00-1.72 for a 10% increase, each vs no change), and variability ≥10% (HR 1.59, 1.09-2.32 for ≥ 30%; HR 1.36, 1.06-1.75 for 20%; and HR 1.17, 1.03-1.32 for 10% variability, each vs 0%) in IGF-I levels were independently associated with mortality.

CONCLUSIONS:

In contrast to data from animal models, low IGF-I levels are associated with higher mortality in older humans. Irrespective of the actual IGF-I level, older individuals with stability of IGF-I levels have lower mortality than those whose IGF-I levels fluctuate over time.

Edited by AlPater

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The Association of Potato Intake with Risk for Incident Type 2 Diabetes in Adults.

Farhadnejad H, Teymoori F, Asghari G, Mirmiran P, Azizi F.

Can J Diabetes. 2018 Feb 26. pii: S1499-2671(17)30947-4. doi: 10.1016/j.jcjd.2018.02.010. [Epub ahead of print]

PMID: 29909965

Abstract

OBJECTIVES:

Previous studies indicate that the risk for diabetes associated with high consumption of potato differs in various populations. We aimed to investigate the associations between total, boiled and fried potato intake and the risk for incident diabetes in Tehranian adults.

METHODS:

This cohort study was conducted in 1,981 adults, aged 19 to 70 years, who participated in the Tehran Lipid and Glucose Study and were followed up for 6 years. Usual dietary potato intakes were assessed using a valid and reliable food-frequency questionnaire. Anthropometric, biochemical and blood pressure data were determined, and diabetes was defined according to the criteria of the American Diabetes Association.

RESULTS:

The mean (± SD) age and potato intake of participants was 38.9±13.4 years and 30.2±30.7 g/day, respectively. The risk for incident diabetes in participants was 6.7% after 6 years of follow up. After adjusting for age, sex, body mass index, physical activity, smoking, family history of diabetes, hypertension, serum triglyceride levels, high-density lipoprotein cholesterol levels, energy intakes and consumption of saturated fat, fruit, whole grains, vegetables, nuts and legumes, the risk for incident diabetes was lower in subjects with higher intakes of total potato (OR=0.46; 95% CI 0.25 to 0.84) and boiled potato (OR=0.47; 95% CI 0.26 to 0.85) in comparison with those who had the lowest intakes (p for trend <0.05). However, there was no significant association between fried potato intake and risk for diabetes (OR=0.50; 95% CI 0.25 to 1.07; p for trend >0.05).

CONCLUSIONS:

Our findings indicate that, in Tehranian adults, a moderate intake of dietary total and boiled, but not fried, potatoes may be associated with a lower risk for incident diabetes.

KEYWORDS:

adult; adulte; boiled potato; consommation de pommes de terre; diabetes; diabète; fried potato; insulin resistance; insulinorésistance; pommes de terre bouillies; pommes de terre frites; potato intake

 

Intentional Weight Loss for Overweight and Obese Knee Osteoarthritis Patients: Is More Better?

Messier SP, Resnik AE, Beavers DP, Mihalko SL, Miller GD, Nicklas BJ, DeVita P, Hunter DJ, Lyles MF, Eckstein F, Guermazi A, Loeser RF.

Arthritis Care Res (Hoboken). 2018 Jun 18. doi: 10.1002/acr.23608. [Epub ahead of print]

PMID: 29911741

Abstract

OBJECTIVE:

To determine the dose response to weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis.

METHODS:

This is a secondary analysis of the diet-only (D) and diet plus exercise (D+E) groups in the Intensive Diet and Exercise for Arthritis (IDEA) randomized controlled clinical trial. Participants were 240 overweight and obese older community-dwelling adults with pain and radiographic knee OA. Participants were divided into 4 groups according to weight loss achieved over an 18-month period; less than 5% (<5% group), between 5 and 10% (≥5% group), between 10 and 20% (≥ 10% group), and greater than 20% (≥20% group).

RESULTS:

There were significant dose responses to weight loss for pain (p = 0.01), function (p = 0.0006), 6-minute walk distance (p < 0.0001), physical (p = 0.0004) and mental (p = 0.03) health- related quality of life (HRQL), knee joint compressive force (p < 0.0001), and IL-6 (p = 0.002). Greater weight loss resulted in superior clinical and mechanstic outcomes with the highest weight loss group (≥20% group) distinguishing itself on all measures compared to the <5% and ≥5% groups; the ≥20% group had 25% less pain and better function than the ≥ 10% group, and significantly (p = 0.006) better physical HRQL.

DISCUSSION:

Long-term weight loss between 10-19.9% of baseline body weight has substantial clinical and mechanistic benefits compared to less weight loss; the value of an additional 10% weight loss includes significantly improved physical HRQL, and a clinically important reduction in pain and improvement in function.

 

Pay more attention to depression as a side-effect of many medications, researchers say

'It's something we don't always think about,' Canadian pharmacist says of U.S. study findings

Nicole Ireland · CBC News · Posted: Jun 18, 2018

http://www.cbc.ca/news/health/second-opinion-depression-as-a-medication-side-effect-1.4710868

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Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States.

Qato DM, Ozenberger K, Olfson M.

JAMA. 2018 Jun 12;319(22):2289-2298. doi: 10.1001/jama.2018.6741.

PMID: 29896627

Abstract

IMPORTANCE:

Prescription medications are increasingly used among adults in the United States and many have a potential for causing depression.

OBJECTIVES:

To characterize use of prescription medications with depression as a potential adverse effect and to assess associations between their use and concurrent depression.

DESIGN, SETTING, AND PARTICIPANTS:

Five 2-year cycles (2005-2006 through 2013-2014) of the National Health and Nutrition Examination Survey, representative cross-sectional surveys of US adults aged 18 years or older, were analyzed for use of medications with depression as a potential adverse effect. Multivariable logistic regression examined associations between use of these medications and concurrent depression. Analyses were performed among adults overall, excluding antidepressant users, and among adults treated with antidepressants and with hypertension.

EXPOSURES:

Prescription medications with depression as a potential adverse effect (listed in Micromedex).

MAIN OUTCOMES AND MEASURES:

Prevalence of any use and concurrent use of medications with a potential to cause depression and prevalence of depression (PHQ-9 score ≥10).

RESULTS:

The study included 26 192 adults (mean age, 46.2 years [95% CI, 45.6-46.7]; women, 51.1%) and 7.6% (95% CI, 7.1%-8.2%) reported depression. The overall estimated prevalence of use of medications with depression as an adverse effect was 37.2%, increasing from 35.0% (95% CI, 32.2%-37.9%) in the cycle years 2005 and 2006 to 38.4% (95% CI, 36.5%-40.3%) in 2013 and 2014 (P for trend = .03). An estimated 6.9% (95% CI, 6.2%-7.6%) reported use of 3 or more concurrent medications with a potential for depression as an adverse effect in 2005 and 2006 and 9.5% (95% CI, 8.4%-10.7%) reported such use in 2013 and 2014 (P for trend = .001). In adjusted analyses excluding users of antidepressants, the number of medications used with depression as possible adverse effects was associated with increased prevalence of concurrent depression. The estimated prevalence of depression was 15% for those reporting use of 3 or more medications with depression as an adverse effect vs 4.7% for those not using such medications (difference, 10.7% [95% CI, 7.2%-14.1%]). These patterns persisted in analyses restricted to adults treated with antidepressants, among hypertensive adults, and after excluding users of any psychotropic medication.

CONCLUSIONS AND RELEVANCE:

In this cross-sectional survey study, use of prescription medications that have depression as a potential adverse effect was common. Use of multiple medications was associated with greater likelihood of concurrent depression.

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[There did not to me seem to be enough confounders adjusted for.]

Exercise and cancer mortality in Korean men and women: a prospective cohort study.

Jee Y, Kim Y, Jee SH, Ryu M.

BMC Public Health. 2018 Jun 19;18(1):761. doi: 10.1186/s12889-018-5669-1.

PMID: 29914427

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5669-1

Abstract

BACKGROUND:

Little is known about longitudinal associations of exercise with different types of cancer, particularly in Asian populations. The purpose of this research was to estimate the association between the duration of exercise and all-cause and cancer-specific mortality.

METHOD:

Data were obtained from the Korean Metabolic Syndrome Mortality Study (KMSMS), a prospective cohort study of 303,428 Korean adults aged 20 years or older at baseline between 1994 and 2004 after exclusion of individuals with missing variables on smoking and exercise. Death certificate-linked data until 31 December 2015 were provided by the Korean National Statistical Office. Cox regression models were constructed to evaluate the associations of exercise with cancer mortality after adjusting for potential confounders such as age, alcohol consumption and smoking status.

RESULTS:

During the follow-up period of 15.3 years (4,638,863 person-years), a total of 16,884 participants died. Both men and women who exercised showed approximately 30% decreased hazards of mortality, compared to those who did no exercise (hazard ratio (HR) 0.70, 95% confidence interval (CI)=0.68-0.73 for men, HR=0.71, CI : 0.67-0.75). A notable observation of this study is the curvilinear associations between the total duration of exercise per week and cancer mortality, with the lowest risk being observed at the low-to-medium levels of exercise; this trend of associations was found for esophagus, liver, lung, and colorectal cancer mortality in men, and all-cause, all-cancer and lung cancer mortality in women.

CONCLUSIONS:

Individuals who exercised showed considerably lower all-cause and cancer mortality risks compared with those who did no exercise. Policies and clinical trials aimed at promoting minimal or moderate participation in exercise may minimize cancer mortality risk.

KEYWORDS:

Exercise; cancer; cohort; death

 

Magnesium and major depression.

Eby GA, Eby KL, Murk H.

In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [internet]. Adelaide (AU): University of Adelaide Press; 2011.

PMID: 29920018 Free Books & Documents

Excerpt

The treatment of major depression (MD) is still a major unmet medical need in the majority of patients. Sixty percent of cases of MD are treatment-resistant depression (TRD), showing that classical treatments for MD are poorly effective to non-effective. Magnesium has been largely removed from processed foods, especially refined grains, in the Western world, harming the brain and causing mood disorders. Magnesium deficiency causes N-methyl-D-aspartate (NMDA) coupled calcium channels to be biased towards opening which causes neuronal injury and neurological dysfunction, which we believe results in MD. Oral administration of Mg to animals produced antidepressant-like effects that were comparable to those of antidepressant drugs. Cerebral spinal fluid (CSF) Mg has been found to be low in suicidal TRD. The first report of Mg treatment for agitated depression was published in 1921 showing success in 220 out of 250 cases. One 2008 randomized clinical trial showed that Mg was as effective as the tricyclic antidepressant imipramine in treating MD. Intravenous and oral Mg protocols have been reported to rapidly terminate MD safely and without side effects. Brain Mg deficiency reduces serotonin levels, and antidepressant drugs have been shown to have the action of raising brain Mg. Excessive calcium, glutamate and aspartate intake can greatly worsen MD. We believe that, when taken together, there is more than sufficient evidence to implicate inadequate dietary Mg as contributing to the cause of MD, and we suggest that physicians prescribe Mg for its prevention and treatment.

Sections

Abstract

Incidence of major depression

Increasing incidence of depression

Classical depression treatments

Treatment-resistant depression

Markers and risk factors of major depression

Biological markers of depression or depression- vulnerability

Changes in dietary magnesium

Regulation of brain magnesium

Changes of serum magnesium in major depression

Functional impact of magnesium

Monoaminergic systems and magnesium

Glutamatergic system and magnesium

Stress hormone systems (HPA and RAAS) and magnesium

Inflammatory system and magnesium

Magnesium in animal and human research

Animal Models and magnesium

Human studies and magnesium

Adverse effect of calcium in depression

Biomarkers of magnesium and magnesium- related functions

Recommendations concerning magnesium- supplementation

Future clinical research

Impediments to success and precautions

Conclusions

References

 

The association of lifetime alcohol use with mortality and cancer risk in older adults: A cohort study.

Kunzmann AT, Coleman HG, Huang WY, Berndt SI.

PLoS Med. 2018 Jun 19;15(6):e1002585. doi: 10.1371/journal.pmed.1002585. eCollection 2018 Jun.

PMID: 29920516

Abstract

BACKGROUND:

While current research is largely consistent as to the harms of heavy drinking in terms of both cancer incidence and mortality, there are disparate messages regarding the safety of light-moderate alcohol consumption, which may confuse public health messages. We aimed to evaluate the association between average lifetime alcohol intakes and risk of both cancer incidence and mortality.

METHODS AND FINDINGS:

We report a population-based cohort study using data from 99,654 adults (68.7% female), aged 55-74 years, participating in the U.S. Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Cox proportional hazards models assessed the risk of overall and cause-specific mortality, cancer incidence (excluding nonmelanoma skin cancer), and combined risk of cancer and death across categories of self-reported average lifetime alcohol intakes, with adjustment for potential confounders. During 836,740 person-years of follow-up (median 8.9 years), 9,599 deaths and 12,763 primary cancers occurred. Positive linear associations were observed between lifetime alcohol consumption and cancer-related mortality and total cancer incidence. J-shaped associations were observed between average lifetime alcohol consumption and overall mortality, cardiovascular-related mortality, and combined risk of death or cancer. In comparison to lifetime light alcohol drinkers (1-3 drinks per week), lifetime never or infrequent drinkers (<1 drink/week), as well as heavy (2-<3 drinks/day) and very heavy drinkers (3+ drinks/day) had increased overall mortality and combined risk of cancer or death. Corresponding hazard ratios (HRs) and 95% confidence intervals (CIs) for combined risk of cancer or death, respectively, were 1.09 (1.01-1.13) for never drinkers, 1.08 (1.03-1.13) for infrequent drinkers, 1.10 (1.02-1.18) for heavy drinkers, and 1.21 (1.13-1.30) for very heavy drinkers. This analysis is limited to older adults, and residual confounding by socioeconomic factors is possible.

CONCLUSIONS:

The study supports a J-shaped association between alcohol and mortality in older adults, which remains after adjustment for cancer risk. The results indicate that intakes below 1 drink per day were associated with the lowest risk of death.

 

Effect of Carbohydrate Intake on Maximal Power Output and Cognitive Performances.

Pomportes L, Brisswalter J, Hays A, Davranche K.

Sports (Basel). 2016 Oct 9;4(4). pii: E49. doi: 10.3390/sports4040049.

PMID: 29910297

Abstract

The present study aimed to assess the beneficial effect of acute carbohydrate (7% CHO) intake on muscular and cognitive performances. Seventeen high levels athletes in explosive sports (fencing and squash) participated in a randomized, double-blind study consisting in series of 6 sprints (5s) with a passive recovery (25s) followed by 15 min submaximal cycling after either maltodextrine and fructose (CHO) or placebo (Pl) intake. Cognitive performances were assessed before and after sprint exercise using a simple reaction time (SRT) task at rest, a visual scanning task (VS) and a Go/Nogo task (GNG) during a submaximal cycling exercise. Results showed a beneficial effect of exercise on VS task on both conditions (Pl: -283 ms; CHO: -423 ms) and on SRT only during CHO condition (-26 ms). In the CHO condition, SRT was faster after exercise whereas no effect of exercise was observed in the Pl condition. According to a qualitative statistical method, a most likely and likely positive effect of CHO was respectively observed on peak power (+4%) and tiredness (-23%) when compared to Pl. Furthermore, a very likely positive effect of CHO was observed on SRT (-8%) and a likely positive effect on visual scanning (-6%) and Go/Nogo tasks (-4%) without any change in accuracy. In conclusion acute ingestion of 250 mL of CHO, 60 min and 30 min before exercise, improve peak power output, decrease muscular tiredness and speed up information processing and visual detection without changing accuracy.

KEYWORDS:

CHO; information processing; maximal muscular performance

 

Mortality rate and causes of death in women with self-reported musculoskeletal pain: Results from a 17-year follow-up study.

Nitter AK, Forseth KØ.

Scand J Pain. 2017 Dec 29;4(2):86-92. doi: 10.1016/j.sjpain.2012.12.002.

PMID: 29913892

https://sci-hub.tw/

Abstract

Aabstract Introduction Chronic musculoskeletal pain represents a significant health problem among adults in Norway. The prevalence of chronic pain is reported to be 35-53% in cross sectional studies of both genders. For many years, it has been a common opinion among medical doctors that chronic pain may indeed reduce a person's quality of life, but not affect life expectancy. However, over the previous two decades, reports about mortality and cause of death in individuals with chronic pain have been published. So far, several studies conclude that there is an increased mortality in patients with chronic pain, but it is not clear what causes this. Increased occurrences of cardio-vascular death or cancer death have been reported in some studies, but not verified in other studies. Aims of the study The aims of this study were to estimate the mortality rate in females with different extent of pain, to identify potential risk factors for death and to investigate if the causes of death differ according to prior reported pain. Methods This is a prospective population-based study of all women between 20 and 50 years registered in Arendal, Norway, in 1989 (N = 2498 individuals). At follow-up in 2007, 2261 living females were retraced, 89 had died. All subjects received a questionnaire containing questions about chronic pain (pain ≥ 3 months duration in muscles, joints, back or the whole body) as well as 13 sub-questions about pain-modulating factors, non-specific health complaints and sleep problems, by mail in 1990, 1995 and 2007. Only subjects who answered the questionnaire in 1990 were included in the analyses. Of the deceased, 71 had answered the questionnaire in 1990. A multivariate model for cox regression analysis was used in order to clarify if chronic pain, sleep problems, feeling anxious, frightened or nervous and number of unspecific health were risk factors for death. The causes of death of 87 of the deceased individuals were obtained by linking the ID-number with the Norwegian Cause of Death Registry. Results The ratio of deceased responders was 2% (14/870) among those with no pain versus 5% (57/1168) among those with chronic pain at baseline. When separating into chronic regional pain and chronic widespread pain, the mortality rate was respectively 4% and 8% in the different groups. Age adjusted hazard ratio for mortality rate in individuals with initially chronic pain was [hr 2.5 (CI 1.4-4.5)] compared to pain free individuals. In the multivariate analysis, having chronic pain [hr 2.1 (1.1-4.2)] and feeling anxious, frightened or nervous [hr 3.2 (1.8-5.6)] were associated with increased risk of death. There was no difference in death from cardiovascular disease or malignancies between the groups of pain free individuals vs. the group of individuals with chronic pain. Conclusion The mortality rate was significantly higher for individuals with chronic pain compared to pain free individuals, adjusted for age. In addition, feeling anxious, frightened or nervous were risk factors for death. There was an increase in all-cause mortality.

KEYWORDS:

Cause of death; Chronic pain; Mortality rate; Population; Risk factor

 

Marriage tied to lower risk of fatal heart attack and stroke

Patients more likely to take important medications after a heart attack or stroke if married

Thomson Reuters · Posted: Jun 19, 2018

http://www.cbc.ca/news/health/marriage-heart-stroke-1.4712108

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Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis FREE

Chun Wai Wong1, Chun Shing Kwok1, Aditya Narain1, Martha Gulati2, Anastasia S Mihalidou3, Pensee Wu4,5, Mirvat Alasnag6, Phyo Kyaw Myint7, Mamas A Mamas

Heart, Online http://dx.doi.org/10.1136/heartjnl-2018-313005

http://heart.bmj.com/content/early/2018/06/06/heartjnl-2018-313005

http://heart.bmj.com/content/heartjnl/early/2018/06/06/heartjnl-2018-313005.full.pdf

Abstract

Background The influence of marital status on the incidence of cardiovascular disease (CVD) and prognosis after CVD is inconclusive. We systematically reviewed the literature to determine how marital status influences CVD and prognosis after CVD.

Methods A search of MEDLINE and Embase in January 2018 without language restriction was performed to identify studies that evaluated the association between marital status and risk of CVD. Search terms related to both marital status and CVD were used and included studies had to be prospective in design. The outcomes of interest were CVD, coronary heart disease (CHD) or stroke incidence and mortality. We performed random effects meta-analysis stratified by the types of population by calculating odds ratios (OR) and 95% confidence intervals (95% CI).

Results Our analysis included 34 studies with more than two million participants. Compared with married participants, being unmarried (never married, divorced or widowed) was associated with increased odds of CVD (OR 1.42; 95% CI 1.00 to 2.01), CHD (OR 1.16,95% CI 1.04 to 1.28), CHD death (OR 1.43,95% CI 1.28 to 1.60) and stroke death (OR 1.55,95% 1.16 to 2.08). Being divorced was associated with increased odds of CHD (P<0.001) for both men and women while widowers were more likely to develop a stroke (P<0.001). Single men and women with myocardial infarction had increased mortality (OR 1.42, 95% CI 1.14 to 1.76) compared with married participants.

Conclusions Marital status appears to influence CVD and prognosis after CVD. These findings may suggest that marital status should be considered in the risk assessment for CVD and outcomes of CVD based on marital status merits further investigation.

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Food restriction promotes damage reduction in rat models of type 2 diabetes mellitus.

Rosa CVDD, Campos JM, Sá Nakanishi AB, Comar JF, Martins IP, Mathias PCF, Pedrosa MMD, Godoi VAF, Natali MRM.

PLoS One. 2018 Jun 20;13(6):e0199479. doi: 10.1371/journal.pone.0199479. eCollection 2018.

PMID: 29924854

Abstract

There are several animal models of type 2 diabetes mellitus induction but the comparison between models is scarce. Food restriction generates benefits, such as reducing oxidative stress, but there are few studies on its effects on diabetes. The objective of this study is to evaluate the differences in physiological and biochemical parameters between diabetes models and their responses to food restriction. For this, 30 male Wistar rats were distributed in 3 groups (n = 10/group): control ©; diabetes with streptozotocin and cafeteria-style diet (DE); and diabetes with streptozotocin and nicotinamide (DN), all treated for two months (pre-food restriction period). Then, the 3 groups were subdivided into 6, generating the groups CC (control), CCR (control+food restriction), DEC (diabetic+standard diet), DER (diabetic+food restriction), DNC (diabetic+standard diet) and DNR (diabetic+food restriction), treated for an additional two months (food restriction period). The food restriction (FR) used was 50% of the average daily dietary intake of group C. Throughout the treatment, physiological and biochemical parameters were evaluated. At the end of the treatment, serum biochemical parameters, oxidative stress and insulin were evaluated. Both diabetic models produced hyperglycemia, polyphagia, polydipsia, insulin resistance, high fructosamine, hepatic damage and reduced insulin, although only DE presented human diabetes-like alterations, such as dyslipidemia and neuropathy symptoms. Both DEC and DNC diabetic groups presented higher levels of protein carbonyl groups associated to lower antioxidant capacity in the plasma. FR promoted improvement of glycemia in DNR, lipid profile in DER, and insulin resistance and hepatic damage in both diabetes models. FR also reduced the protein carbonyl groups of both DER and DNR diabetic groups, but the antioxidant capacity was improved only in the plasma of DER group. It is concluded that FR is beneficial for diabetes but should be used in conjunction with other therapies.

 

Dietary Long-Chain n-3 Fatty Acid Intake and Arthritis Risk in the Women's Health Initiative.

Krok-Schoen JL, Brasky TM, Hunt RP, Rohan TE, Baker TA, Li W, Carbone L, Mackey RH, Snetselaar L, Lustberg MB, Neuhouser ML.

J Acad Nutr Diet. 2018 Jun 16. pii: S2212-2672(18)30492-1. doi: 10.1016/j.jand.2018.04.005. [Epub ahead of print]

PMID: 29921541

Abstract

BACKGROUND:

The prevalence of arthritis in the United States is substantial and on the rise. Long-chain n-3 polyunsaturated fatty acids, which have anti-inflammatory properties, have been shown to provide therapeutic benefit to arthritis patients; however, to date few have examined these associations with arthritis risk.

OBJECTIVE:

The study objective was to examine the associations of long-chain n-3 polyunsaturated fatty acids intake with osteoarthritis (OA) and rheumatoid arthritis (RA) risk among postmenopausal women.

DESIGN:

This was a prospective cohort study.

PARTICIPANTS:

The sample for this analysis consisted of 80,551 postmenopausal women, aged 55 to 79 years and with no history of arthritis, recruited into the Women's Health Initiative Observational Study and Clinical Trials cohort between 1993 and 1998. Women completed a 120-item food frequency questionnaire at baseline.

MAIN OUTCOME MEASURES:

After a median follow-up of 8 years, 22,306 incident OA and 3,348 RA cases were identified.

STATISTICAL ANALYSES PERFORMED:

Adjusted Cox regression models were used to estimate hazard ratios and 95% CI for the associations between dietary LCn-3PUFA intake and OA and RA risk.

RESULTS:

Individual and total long-chain n-3 polyunsaturated fatty acids (Quintile 5 vs Quintile 1: hazard ratio 1.04, 95% CI 0.99 to 1.09 for OA; hazard ratio 1.01, 95% CI 0.90 to 1.13 for RA) were not associated with OA and RA risk. Further, no associations were observed between n-6 polyunsaturated fatty acids intake and either arthritis outcome.

CONCLUSIONS:

This study is the first to examine associations of long-chain n-3 polyunsaturated fatty acids intake with OA risk and the largest to examine associations with RA risk. Despite their therapeutic potential, the study provides no evidence of benefit of these nutrients in relation to arthritis risk.

KEYWORDS:

Arthritis; Osteoarthritis; Rheumatoid arthritis; Women’s Health Initiative; n-3 fatty acids

 

Waist-to-height ratio index for predicting incidences of hypertension: the ARIRANG study.

Choi JR, Koh SB, Choi E.

BMC Public Health. 2018 Jun 19;18(1):767. doi: 10.1186/s12889-018-5662-8.

PMID: 29921256

Abstract

BACKGROUND:

Several anthropometric indices such as body mass index (BMI) and waist circumference (WC) have been examined as indicators of cardiovascular diseases, in both adults and children. However, the waist-to-height ratio (WHtR) is considered a better predictor for the detection of cardiovascular risk factors, than BMI. We investigated the association between the WHtR and incident hypertension.

METHODS:

A total of 1718 participants, aged 39-72 years, were recruited in this longitudinal study. Participants were divided into 2 groups according to the development of hypertension during 2005-2008 (baseline) and 2008-2011 (follow-up). Logistic regression models were used to evaluate the WHtR as a significant predictor of hypertension.

RESULTS:

During the 2.8 years of follow-up, 185 new cases of hypertension (10.8%) were diagnosed, with an incidence rate of approximately 4% per year. The WHtR was significantly higher in the participants who had developed hypertension than in those who had not (0.54 ± 0.05 vs. 0.51 ± 0.05, p < 0.001). After adjusting for age, sex, smoking status, alcohol intake, regular exercise status, total cholesterol, and systolic blood pressure, at the baseline, the logistic regression analysis indicated that the participants with the highest quartile of the WHtR (WHtR≥0.54) were 4.51 times more likely to have hypertension than those with the lowest quartile (odds ratio 4.51; 95% confidence interval 2.41-8.43; p < .0001). The area under the curve for the WHtR, in identifying hypertension risk, was significantly greater than that for the BMI (p = 0.0233).

CONCLUSION:

A positive association between WHtR and the incidence of hypertension was observed in Korean adults. The findings of the present community-based prospective study suggest that the WHtR may be a better predictor of incident hypertension.

KEYWORDS:

Community-based prospective study; Hypertension; Korean adults; Predictor; Waist-to-height ratio

 

Interaction between an ADCY3 Genetic Variant and Two Weight-Lowering Diets Affecting Body Fatness and Body Composition Outcomes Depending on Macronutrient Distribution: A Randomized Trial.

Goni L, Riezu-Boj JI, Milagro FI, Corrales FJ, Ortiz L, Cuervo M, Martínez JA.

Nutrients. 2018 Jun 19;10(6). pii: E789. doi: 10.3390/nu10060789.

PMID: 29921800

http://www.mdpi.com/2072-6643/10/6/789/htm

Abstract

The adenylate cyclase 3 (ADCY3) gene is involved in the regulation of several metabolic processes including the development and function of adipose tissue. The effects of the ADCY3 rs10182181 genetic variant on changes in body composition depending on the macronutrient distribution intake after 16 weeks of the dietary intervention were tested. The ADCY3 genetic variant was genotyped in 147 overweight or obese subjects, who were randomly assigned to one of the two diets varying in macronutrient content: a moderately-high-protein diet and a low-fat diet. Anthropometric and body composition measurements (DEXA scan) were recorded. Significant interactions between the ADCY3 genotype and dietary intervention on changes in weight, waist circumference, and body composition were found after adjustment for covariates. Thus, in the moderately-high-protein diet group, the G allele was associated with a lower decrease of fat mass, trunk and android fat, and a greater decrease in lean mass. Conversely, in the low-fat diet group carrying the G allele was associated with a greater decrease in trunk, android, gynoid, and visceral fat. Subjects carrying the G allele of the rs10182181 polymorphism may benefit more in terms of weight loss and improvement of body composition measurements when undertaking a hypocaloric low-fat diet as compared to a moderately-high-protein diet.

KEYWORDS:

ADCY3; body composition; body fatness; energy restricted diet; gene–diet interaction

 

Body mass index, abdominal fatness, and hypertension incidence: a dose-response meta-analysis of prospective studies.

Zhou W, Shi Y, Li YQ, Ping Z, Wang C, Liu X, Lu J, Mao ZX, Zhao J, Yin L, Zhang D, Tian Z, Zhang L, Li L.

J Hum Hypertens. 2018 May;32(5):321-333. doi: 10.1038/s41371-018-0046-1. Epub 2018 Mar 27.

PMID: 29581553

https://sci-hub.tw/

Abstract

Despite the established relationship of obesity to hypertension, the question as to whether there is a linear association between these two morbidities is unanswered. To quantitatively evaluate the relationship between obesity and hypertension, we carried out a dose-response meta-analysis of studies that looked at the relationship of different adiposity measures to hypertension. We searched PubMed, Embase, and Web of Science databases for articles published before 27 June 2017. A random-effects model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the relationship. A total of 59 studies were included. Fifty-seven cohort studies with 125,071 incident cases among 830,685 participants were included in the analysis of body mass index and hypertension with the summary relative risk for per 5-unit increment in body mass index of 1.50 (95% confidence interval: 1.40-1.59). We found that the risk of hypertension in the body mass index analysis was greater in populations where the baseline body mass index was <25 kg/m2. The summary relative risk for a 10-cm increase in waist circumference was 1.25 (95% confidence interval: 1.19-1.32) and per 0.1-unit increase in waist-to-hip ratio was 1.27 (95% confidence interval: 1.18-1.37). This meta-analysis suggests that in normal range of obesity indexes, as lean as possible may be the best suggestion to prevent hypertension incidence.

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Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review.

Ford AR, Siegel M, Bagel J, Cordoro KM, Garg A, Gottlieb A, Green LJ, Gudjonsson JE, Koo J, Lebwohl M, Liao W, Mandelin AM 2nd, Markenson JA, Mehta N, Merola JF, Prussick R, Ryan C, Schwartzman S, Siegel EL, Van Voorhees AS, Wu JJ, Armstrong AW.

JAMA Dermatol. 2018 Jun 20. doi: 10.1001/jamadermatol.2018.1412. [Epub ahead of print]

PMID: 29926091

Abstract

IMPORTANCE:

Psoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases.

OBJECTIVE:

To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation.

EVIDENCE REVIEW:

We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of patients with psoriasis or psoriatic arthritis. The quality of included studies was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. We made evidence-based dietary recommendations, which were voted on by the National Psoriasis Foundation Medical Board.

FINDINGS:

We identified 55 studies meeting the inclusion criteria for this review. These studies represent 77 557 unique participants of which 4534 have psoriasis. Based on the literature, we strongly recommend dietary weight reduction with a hypocaloric diet in overweight and obese patients with psoriasis. We weakly recommend a gluten-free diet only in patients who test positive for serologic markers of gluten sensitivity. Based on low-quality data, select foods, nutrients, and dietary patterns may affect psoriasis. For patients with psoriatic arthritis, we weakly recommend vitamin D supplementation and dietary weight reduction with a hypocaloric diet in overweight and obese patients. Dietary interventions should always be used in conjunction with standard medical therapies for psoriasis and psoriatic arthritis.

CONCLUSIONS AND RELEVANCE:

Adults with psoriasis and/or psoriatic arthritis can supplement their standard medical therapies with dietary interventions to reduce disease severity. These dietary recommendations from the National Psoriasis Foundation Medical Board will help guide clinicians regarding the utility of dietary interventions in adults with psoriatic diseases.

 

Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study.

Zhou D, Xi B, Zhao M, Wang L, Veeranki SP.

Sci Rep. 2018 Jun 20;8(1):9418. doi: 10.1038/s41598-018-27377-2.

PMID: 29925884

https://www.nature.com/articles/s41598-018-27377-2.pdf

Abstract

Clinical trials had provided evidence for the benefit effect of antihypertensive treatments in preventing future cardiovascular disease (CVD) events; however, the association between hypertension, whether treated/untreated or controlled/uncontrolled and risk of mortality in US population has been poorly understood. A total of 13,947 US adults aged ≥18 years enrolled in the Third National Health and Nutrition Examination Survey (1988-1994) were used to conduct this study. Mortality outcome events included all-cause, CVD-specific, heart disease-specific and cerebrovascular disease-specific deaths, which were obtained from linked 2011 National Death Index (NDI) files. During a median follow-up of 19.1 years, there were 3,550 all-cause deaths, including 1,027 CVD deaths. Compared with normotensives, treated but uncontrolled hypertensive patients were at higher risk of all-cause (HR = 1.62, 95%CI = 1.35-1.95), CVD-specific (HR = 2.23, 95%CI = 1.66-2.99), heart disease-specific (HR = 2.19, 95%CI = 1.57-3.05) and cerebrovascular disease-specific (HR = 3.01, 95%CI = 1.91-4.73) mortality. Additionally, untreated hypertensive patients had increased risk of all-cause (HR = 1.40, 95%CI = 1.21-1.62), CVD-specific (HR = 1.77, 95%CI = 1.34-2.35), heart disease-specific (HR = 1.69, 95%CI = 1.23-2.32) and cerebrovascular disease-specific death (HR = 2.53, 95%CI = 1.52-4.23). No significant differences were identified between normotensives, and treated and controlled hypertensives (all p > 0.05). Our study findings emphasize the benefit of secondary prevention in hypertensive patients and primary prevention in general population to prevent risk of mortality later in life.

 

Vitamin D levels in an Australian and New Zealand cohort and the association with pregnancy outcome.

Wilson RL, Leviton AJ, Leemaqz SY, Anderson PH, Grieger JA, Grzeskowiak LE, Verburg PE, McCowan L, Dekker GA, Bianco-Miotto T, Roberts CT.

BMC Pregnancy Childbirth. 2018 Jun 20;18(1):251. doi: 10.1186/s12884-018-1887-x.

PMID: 29925344

Abstract

BACKGROUND:

Pregnant women are at increased susceptibility to vitamin D deficiency. Hence, there is continuing interest in determining how vitamin D influences pregnancy health. We aimed to compare vitamin D status in two distinct populations of pregnant women in Australia and New Zealand and to investigate the relationship between vitamin D status and pregnancy outcome. This included evaluating possible effect measure modifications according to fetal sex.

METHODS:

Serum 25-hydroxy vitamin D (25(OH)D) was measured at 15 ± 1 weeks' gestation in 2800 women from Adelaide and Auckland who participated in the multi-centre, prospective cohort SCreening fOr Pregnancy Endpoints (SCOPE) study.

RESULTS:

Mean serum 25(OH)D in all women was 68.1 ± 27.1 nmol/L and 28% (n = 772) were considered vitamin D deficient (< 50 nmol/L). Serum 25(OH)D was lower in the women recruited in Adelaide when compared to the women recruited in Auckland and remained lower after adjusting for covariates including maternal body mass index and socioeconomic index (Adelaide: 58.4 ± 50.3 vs. Auckland: 70.2 ± 54.5 nmol/L, P < 0.001). A 53% decreased risk for gestational diabetes mellitus (GDM) was observed with high (> 81 nmol/L) "standardised" vitamin D status when compared to moderate-high (63-81 nmol/L, aRR, 0.47; 95% CI: 0.23, 0.96). Marginal sex-specific differences occurred between vitamin D status and GDM: women carrying a female fetus had a 56% decreased risk for GDM in those with low-moderate levels of standardised vitamin D (44-63 nmol/L) compared to moderate-high levels (aRR: 0.44; 95% CI: 0.20, 0.97), whilst in women carrying a male fetus, a 55% decreased risk of GDM was found with high standardised vitamin D when compared to moderately-high vitamin D, but this was not statistically significant (aRR: 0.45; 95% CI: 0.15, 1.38).

CONCLUSIONS:

High serum 25(OH)D at 15 ± 1 weeks' gestation was shown to be protective against the development of GDM. A possible association between fetal sex, vitamin D status and GDM provides further questions and encourages continual research and discussion into the role of vitamin D in pregnancy, particularly in vitamin D replete populations.

KEYWORDS:

Fetal sex; Gestational diabetes mellitus; Pregnancy; Pregnancy outcome; Vitamin D

 

Blood-pressure-lowering interventions to prevent dementia: a systematic review and meta-analysis.

van Middelaar T, van Vught LA, van Gool WA, Simons EMF, van den Born BH, Moll van Charante EP, Richard E.

J Hypertens. 2018 Jun 20. doi: 10.1097/HJH.0000000000001829. [Epub ahead of print]

PMID: 29927845

Abstract

: Our objective was to study the preventive effect of lowering blood pressure (BP) by medication and/or lifestyle changes on incident all-cause dementia, Alzheimer's disease and vascular dementia. In this systematic review, we included randomized controlled trials with a BP-lowering intervention. Of the nine included trials, seven assessed the effect of antihypertensive medication and two of a lifestyle or combined intervention. In the intervention arm, 1041 out of 29 029 (3.6%) participants were diagnosed with dementia compared with 1090 out of 28 653 (3.8%) controls during a median follow-up of 3.9 years [range 2-10], resulting in a pooled risk ratio of 0.93 (95% confidence interval 0.84-1.02; I 16%). Three trials specified dementia subtypes, with no significant effect on Alzheimer's disease or vascular dementia. To conclude, lowering BP by medication and/or lifestyle changes did not lead to a significantly reduced risk of dementia. This appeared independent of dementia subtype.

 

The Benefits of Running vs. Walking

Which is better? It all depends on your goals.

By Sally Wadyka

June 18, 2018

https://www.consumerreports.org/exercise-fitness/benefits-of-running-vs-walking/

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Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction.

Williams PT, Thompson PD.

Arterioscler Thromb Vasc Biol. 2013 May;33(5):1085-91. doi: 10.1161/ATVBAHA.112.300878. Epub 2013 Apr 4.

PMID: 23559628 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4067492/pdf/nihms-450905.pdf

Abstract

OBJECTIVE:

To test whether equivalent energy expenditure by moderate-intensity (eg, walking) and vigorous-intensity exercise (eg, running) provides equivalent health benefits.

APPROACH AND RESULTS:

We used the National Runners' (n=33 060) and Walkers' (n=15 945) Health Study cohorts to examine the effect of differences in exercise mode and thereby exercise intensity on coronary heart disease (CHD) risk factors. Baseline expenditure (metabolic equivant hours per day [METh/d]) was compared with self-reported, physician-diagnosed incident hypertension, hypercholesterolemia, diabetes mellitus, and CHD during 6.2 years follow-up. Running significantly decreased the risks for incident hypertension by 4.2% (P<10(-7)), hypercholesterolemia by 4.3% (P<10(-14)), diabetes mellitus by 12.1% (P<10(-5)), and CHD by 4.5% per METh/d (P=0.05). The corresponding reductions for walking were 7.2% (P<10(-6)), 7.0% (P<10(-8)), 12.3% (P<10(-4)), and 9.3% (P=0.01). Relative to <1.8 METh/d, the risk reductions for 1.8 to 3.6, 3.6 to 5.4, 5.4 to 7.2, and ≥7.2 METh/d were as follows: (1) 10.1%, 17.7%, 25.1%, and 34.9% from running and 14.0%, 23.8%, 21.8%, and 38.3% from walking for hypercholesterolemia; (2) 19.7%, 19.4%, 26.8%, and 39.8% from running and 14.7%, 19.1%, 23.6%, and 13.3% from walking for hypertension; and (3) 43.5%, 44.1%, 47.7%, and 68.2% from running, and 34.1%, 44.2% and 23.6% from walking for diabetes mellitus (walking >5.4 METh/d excluded for too few cases). The risk reductions were not significantly different for running than walking for diabetes mellitus (P=0.94), hypertension (P=0.06), or CHD (P=0.26), and only marginally greater for walking than running for hypercholesterolemia (P=0.04).

CONCLUSIONS:

Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD.

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Factors associated with progression to pre-diabetes: a recurrent events analysis.

Mansourian M, Yazdani A, Faghihimani E, Aminorraya A, Amini M, Jafari-Koshki T.

Eat Weight Disord. 2018 Jun 22. doi: 10.1007/s40519-018-0529-7. [Epub ahead of print]

PMID: 29931448

Abstract

AIMS:

Pre-diabetes is a strong risk factor for type 2diabetes (T2D). The aim of this study was to explore factors associated with normal glucose maintenance and pre-diabetes prevention or delay.

METHODS:

Data of 1016 first-degree relatives of T2D patients were retrieved from the Isfahan Diabetes Prevention Study (IDPS). Association of various variables including nutrients, serum tests and physical activity with the risk of pre-diabetes was assessed using recurrent events approach.

RESULTS:

Cumulative incidence of diabetes was 8.17, 9.44, and 4.91% for total sample and individuals with and without pre-diabetes experience in the follow-up. Risk of progression to pre-diabetes was higher in women and older people (p < 0.01). Additionally, BMI and blood pressure had significant association with the risk (p < 0.01) and individuals with higher intake of fat were at higher risk (HR = 2.26; 95% CI 1.66-3.07 for high-intake and HR = 1.52; 95% CI 1.27-1.83 for medium-intake compared to low-intake group). Carbohydrates and protein intake were positively associated with the risk of pre-diabetes with HR = 8.63 per 49 g extra carbohydrates per day and HR = 1.32 per 6 g extra protein per day (p < 0.01). The association was also significant for triglyceride (TG) with 7% risk increase per 1 SD = 1.14 increase in TG level.

CONCLUSION:

Despite frequent studies on lifestyle modification for pre-diabetes prevention, less information is available about the role of nutritional components. We observed direct effects for intake of macronutrients including fat, carbohydrates, and protein in first-degree relatives. Further research is warranted to assess these associations in general populations.

LEVEL OF EVIDENCE:

Level III: Evidence obtained from a single-center cohort study.

KEYWORDS:

Pre-diabetes; Relatives; Risk factor; Type 2 diabetes

 

Aspirin-another caloric-restriction mimetic.

Pietrocola F, Castoldi F, Maiuri MC, Kroemer G.

Autophagy. 2018 Jun 21. doi: 10.1080/15548627.2018.1454810. [Epub ahead of print]

PMID: 29929449

Abstract

The capacity of cells and organisms to sustain, and to eventually adapt to, environmental and genetic insults declines with age. Because macroautophagy/autophagy is regarded as one of the major determinants of cellular fitness in vitro and in vivo, maneuvers that aim at promoting autophagy may slow down aging and promote health span. Caloric restriction (CR), a reduction in caloric intake without malnutrition, efficiently counteracts aging-associated features, yet is difficult to be applied to humans. Caloric-restriction mimetics (CRMs) are pharmacological agents that recapitulate the main biochemical properties of CR, namely a global reduction of protein acetylation and the induction of autophagy. We found that the ancient drug aspirin and its active metabolite salicylate stimulate autophagic flux by virtue of their inhibitory action on acetyltransferase EP300. The inhibition of EP300 results from a direct competition between salicylate and acetyl coenzyme A for binding to the catalytic domain of the enzyme. This mode of action appears to be conserved across evolution as it accounts for the induction of autophagy by aspirin in various mouse models and in the nematode Caenorhabditis elegans. In sum, aspirin acts as a CRM.

KEYWORDS:

AMPK; acetylation; aging; autophagy, C.elegans; fasting; inflammation; longevity; mitophagy; salicylate

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Resveratrol prolongs lifespan and improves 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced oxidative damage and behavioural deficits in Drosophila melanogaster.

Abolaji AO, Adedara AO, Adie MA, Vicente-Crespo M, Farombi EO.

Biochem Biophys Res Commun. 2018 Jun 20. pii: S0006-291X(18)31426-8. doi: 10.1016/j.bbrc.2018.06.114. [Epub ahead of print]

PMID: 29935183

Abstract

1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine (MPTP) is a neurotoxin with Parkinson's disease traits in animals via mechanisms linked with oxidative stress and inflammation. Resveratrol is a natural polyphenol and a phytoalexin with antioxidative and antiinflammatory properties. Here, we investigated the rescue role of resveratrol on MPTP-triggered toxicity in Drosophila melanogaster for the first time. D. melanogaster (Harwich strain, 1-to 3- days old) were first orally exposed to resveratrol (0, 7.5, 15, 30, and 60 mg/kg diet) and MPTP (0, 250, 500, 1000, 2000, and 3000 μM) for longevity and 7 days survival assays respectively. Consequently, we selected resveratrol (30 and 60 mg/kg diet) to evaluate its rescue role of on MPTPT (250 and 500 μM)-induced toxicity in D. melanogaster after 3 days of oral treatment. Specifically, we evaluated markers of neurotoxicity (acetylcholinesterase (AChE) and negative geotaxis), inflammation (nitric oxide (NO)), oxidative stress-antioxidant status ((hydrogen peroxide (H2O2), total thiol (T-SH), catalase and glutathione-S-transferase (GST)), cell viability and fecundity. The data showed that resveratrol (7.5, 15, 30, and 60 mg/kg diet) increased lifespan of D. melanogaster by 18.6, 20.9, 39.5 and 41.9% respectively. Further, resveratrol restored MPTP-induced inhibition of catalase, GST and AChE activities in D. melanogaster. Moreover, resveratrol ameliorated MPTP-triggered cell death, histological alterations, behavioural deficits and accumulation of nitric oxide and hydrogen peroxide levels in flies (p < 0.05). Conclusively, the lifespan extension effects of resveratrol and its rescue role on MPTP- mediated toxicity in the flies may be due to its antioxidant and anti-inflammatory properties.

KEYWORDS:

1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine; Oxidative stress; Parkinson's disease; Resveratrol

 

PERSONAL HEALTH

How to Increase Your Chances of Having a Long, Healthy Life

By Jane E. Brody

June 4, 2018

https://www.nytimes.com/2018/06/04/well/how-to-increase-your-chances-of-having-a-long-healthy-life.html?fb=0&recb=home-living.thompson_sampling&recid=16T4OK4WAkV3gDGB1MYZolFRejR&contentCollection=smarter-living&mData=articles%255B%255D%3Dhttps%253A%252F%252Fwww.nytimes.com%252F2018%252F06%252F04%252Fwell%252Fhow-to-increase-your-chances-of-having-a-long-healthy-life.html%253Ffb%253D0%2526recb%253Dhome-living.thompson_sampling%2526recid%253D16T4OK4WAkV3gDGB1MYZolFRejR%26articles%255B%255D%3Dhttps%253A%252F%252Fwww.nytimes.com%252F2018%252F06%252F14%252Fus%252Fflag-day-us-code.html%253Ffb%253D0%2526recb%253Dhome-living.thompson_sampling%2526recid%253D16T4OK4WAkV3gDGB1MYZolFRejR&hp&action=click&pgtype=Homepage&clickSource=story-heading&module=smarterLiving-promo-region&region=smarterLiving-promo-region&WT.nav=smarterLiving-promo-region

"Minnesotans joke that the long months of subfreezing temperatures preserve them, but Dr. Christopher J.L. Murray, the new study’s lead author, told me, “Living in cold is pretty bad for you; Minnesotans would probably be even healthier if it wasn’t so cold there.”"

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The State of US Health, 1990-2016

Burden of Diseases, Injuries, and Risk Factors Among US States

The US Burden of Disease Collaborators

JAMA. 2018;319(14):1444-1472. doi:10.1001/jama.2018.0158

https://jamanetwork.com/journals/jama/fullarticle/2678018

==========

Editorial

Toward a United States of Health: Implications of Understanding the US Burden of Disease

Howard K. Koh, MD, MPH1,2; Anand K. Parekh, MD, MPH3

JAMA. 2018;319(14):1438-1440. doi:10.1001/jama.2018.0157

https://sci-hub.tw/10.1001/jama.2018.0157

Healthy People 2020, which establishes the health agenda for the United States, promotes a societal vision whereby all individuals lead long healthy lives free of preventable disease, disability, injury, and premature death. Yet new evidence in this issue of JAMA finds that vision well beyond the reach of far too many people.1

Since 1990, the Global Burden of Disease (GBD) study has pioneered a series of investigations that rank countries through a comprehensive set of health and disease measures. GBD 2016, which includes a focus on US and state health outcomes (1990-2016), highlights an array of substantial, mostly preventable, physical, mental, and social burdens. Despite notable improvements in some outcomes, the US disease burden is shared unequally. Prior research has established that the United States, like many other nations, is aging and increasingly diverse in terms of race and ethnicity, socioeconomic status, sexual orientation, and gender identity. Now GBD 2016 also documents key health disparities by geography that leave the United States far from being united. These findings have broad implications for clinicians and policy makers, as well as specific implications related to certain risk factors and conditions.

...

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

US Burden of Diseases, Injuries, and Disease Risk Factors, 1990-2016

Key Points

Question How have the levels and trends of burden of diseases, injuries, and risk factors in the United States changed from 1990 to 2016 by state?

Findings This study, involving examination of 333 causes and 84 risk factors, demonstrated that health in the United States improved from 1990 to 2016, although the drivers of mortality and morbidity have changed in some states, with specific risk factors such as drug use disorders, high body mass index (BMI), and alcohol use disorders being associated with adverse outcomes. In 5 states, the probability of death between ages 20 and 55 years has increased more than 10% between 1990 and 2016.

Meaning Differences in health outcomes and drivers of morbidity and mortality at the state level indicate the need for greater investment in preventive and medical care across the life course. The intersection of risk, mortality, and morbidity in particular geographic areas needs to be further explored at the state level.

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

Abstract

Introduction Several studies have measured health outcomes in the United States, but none have provided a comprehensive assessment of patterns of health by state.

Objective To use the results of the Global Burden of Disease Study (GBD) to report trends in the burden of diseases, injuries, and risk factors at the state level from 1990 to 2016.

Design and Setting A systematic analysis of published studies and available data sources estimates the burden of disease by age, sex, geography, and year.

Main Outcomes and Measures Prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 333 causes and 84 risk factors with 95% uncertainty intervals (UIs) were computed.

Results Between 1990 and 2016, overall death rates in the United States declined from 745.2 (95% UI, 740.6 to 749.8) per 100 000 persons to 578.0 (95% UI, 569.4 to 587.1) per 100 000 persons. The probability of death among adults aged 20 to 55 years declined in 31 states and Washington, DC from 1990 to 2016. In 2016, Hawaii had the highest life expectancy at birth (81.3 years) and Mississippi had the lowest (74.7 years), a 6.6-year difference. Minnesota had the highest HALE at birth (70.3 years), and West Virginia had the lowest (63.8 years), a 6.5-year difference. The leading causes of DALYs in the United States for 1990 and 2016 were ischemic heart disease and lung cancer, while the third leading cause in 1990 was low back pain, and the third leading cause in 2016 was chronic obstructive pulmonary disease. Opioid use disorders moved from the 11th leading cause of DALYs in 1990 to the 7th leading cause in 2016, representing a 74.5% (95% UI, 42.8% to 93.9%) change. In 2016, each of the following 6 risks individually accounted for more than 5% of risk-attributable DALYs: tobacco consumption, high body mass index (BMI), poor diet, alcohol and drug use, high fasting plasma glucose, and high blood pressure. Across all US states, the top risk factors in terms of attributable DALYs were due to 1 of the 3 following causes: tobacco consumption (32 states), high BMI (10 states), or alcohol and drug use (8 states).

Conclusions and Relevance There are wide differences in the burden of disease at the state level. Specific diseases and risk factors, such as drug use disorders, high BMI, poor diet, high fasting plasma glucose level, and alcohol use disorders are increasing and warrant increased attention. These data can be used to inform national health priorities for research, clinical care, and policy.

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Cause-specific mortality by partnership status: simultaneous analysis using longitudinal data from England and Wales.

Franke S, Kulu H.

J Epidemiol Community Health. 2018 Jun 23. pii: jech-2017-210339. doi: 10.1136/jech-2017-210339. [Epub ahead of print]

PMID: 29936421

Abstract

BACKGROUND:

This paper examines cause-specific mortality by partnership status. Although non-marital cohabitation has spread rapidly in industrialised countries, only a few studies have investigated mortality by partnership status and no recent study has investigated cause-specific mortality by partnership status.

METHODS:

We use data from the Office for National Statistics Longitudinal Study and apply competing risks survival models.

RESULTS:

The simultaneous analysis shows that married individuals have lower mortality than non-married from circulatory, respiratory, digestive, alcohol and accident related causes of deaths, but not from cancer. The analysis by partnership status reveals that once we distinguish premarital and postmarital cohabitants from other non-married groups, the differences between partnered and non-partnered individuals become even more pronounced for all causes of death; this is largely due to similar cause-specific mortality levels between married and cohabiting individuals.

CONCLUSIONS:

With declining marriage rates and the spread of cohabitation and separation, a distinction between partnered and non-partnered individuals is critical to understanding whether and how having a partner shapes the individuals' health behaviour and mortality. The cause-specific analysis supports both the importance of selection into partnership and the protective effect of living with someone together.

KEYWORDS:

longitudinal studies; marital status; mortality

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Cedar Pollinosis and Mortality: A Population-Based Prospective Cohort Study in Japan.

Mori K, Wada K, Konishi K, Goto Y, Mizuta F, Koda S, Uji T, Ito Y, Nagata C.

J Epidemiol. 2018 Jun 23. doi: 10.2188/jea.JE20170278. [Epub ahead of print]

PMID: 29937471

Abstract

BACKGROUND:

Cedar pollinosis is one of the most prevalent forms of seasonal allergic reaction in Japan. Only one prospective study has examined the association between cedar pollinosis and mortality. Using a symptom-based questionnaire on cedar pollinosis, we investigated the association of cedar pollinosis with all-cause and cause-specific mortality.

METHODS:

Data came from the Takayama Study, which recruited residents aged ≥35 years in 1992 from Takayama city in Gifu Prefecture, Japan. The current study used information on cedar pollinosis that was obtained from the second survey in 2002. A total of 12,471 persons who were 45-80 years old and had no history of cancer, coronary heart disease, or stroke responded to a questionnaire asking about four symptoms related to cedar pollinosis. Mortality and migration data were obtained throughout the follow-up period up to March 2013. Cox proportional hazard models were used to examine the relation between cedar pollinosis and mortality.

RESULTS:

A total of 1,276 persons died during follow-up period. Among these, there were 504 neoplasm, 278 cardiovascular, and 181 respiratory deaths. After adjusting for potential confounders, cedar pollinosis was associated with significantly lower all-cause mortality (hazard ratio {HR} 0.79; 95% confidence interval [CI], 0.65-0.95) and respiratory mortality (HR 0.38; 95% CI, 0.18-0.82). There was no significant association between cedar pollinosis and mortality due to neoplasm or cardiovascular disease.

CONCLUSIONS:

We found an inverse association between cedar pollinosis and the risk of all-cause and respiratory mortality. Further research is needed to elucidate the association between cedar pollinosis and mortality.

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Pollinosis and all-cause mortality among middle-aged and elderly Japanese: a population-based cohort study.

Konishi S, Ng CF, Stickley A, Watanabe C.

Clin Exp Allergy. 2016 Aug;46(8):1083-9. doi: 10.1111/cea.12638. Epub 2016 May 3.

PMID: 26366720

https://sci-hub.tw/

Abstract

BACKGROUND:

Having an allergic disease may have health implications beyond those more commonly associated with allergy given that previous epidemiological studies have suggested that both atopy and allergy are linked to mortality. More viable immune functioning among the elderly, as indicated by the presence of an allergic disease, might therefore be associated with differences in all-cause mortality.

OBJECTIVE:

Using data from a Japanese cohort, this study examined whether having pollinosis (a form of allergic rhinitis) in a follow-up survey could predict all-cause and cause-specific mortality.

METHODS:

Data came from the Komo-Ise cohort, which at its 1993 baseline recruited residents aged 40-69 years from two areas in Gunma prefecture, Japan. The current study used information on pollinosis that was obtained from the follow-up survey in 2000. Mortality and migration data were obtained throughout the follow-up period up to December 2008. Proportional hazard models were used to examine the relation between pollinosis and mortality.

RESULTS:

At the 2000 follow-up survey, 12% (1088 of 8796) of respondents reported that they had pollinosis symptoms in the past 12 months. During the 76 186 person-years of follow-up, 748 died from all causes. Among these, there were 37 external, 208 cardiovascular, 74 respiratory, and 329 neoplasm deaths. After adjusting for potential confounders, pollinosis was associated with significantly lower all-cause [hazard ratio 0.57 (95% confidence interval = 0.38-0.87)] and neoplasms mortality [hazard ratio 0.48 (95% confidence interval = 0.26-0.92)].

CONCLUSIONS AND CLINICAL RELEVANCE:

Having an allergic disease (pollinosis) at an older age may be indicative of more viable immune functioning and be protective against certain causes of death. Further research is needed to determine the possible mechanisms underlying the association between pollinosis and mortality.

KEYWORDS:

all-cause mortality; cohort study; elderly; pollinosis

 

Nutrients, Nutraceuticals, and Xenobiotics Affecting Renal Health.

Cosola C, Sabatino A, di Bari I, Fiaccadori E, Gesualdo L.

Nutrients. 2018 Jun 23;10(7). pii: E808. doi: 10.3390/nu10070808. Review.

PMID: 29937486

http://www.mdpi.com/2072-6643/10/7/808/htm

Abstract

Chronic kidney disease (CKD) affects 8⁻16% of the population worldwide. In developed countries, the most important risk factors for CKD are diabetes, hypertension, and obesity, calling into question the importance of educating and acting on lifestyles and nutrition. A balanced diet and supplementation can indeed support the maintenance of a general health status, including preservation of renal function, and can help to manage and curb the main risk factors for renal damage. While the concept of protein and salt restriction in nephrology is historically acknowledged, the role of some nutrients in renal health and the importance of nutrition as a preventative measure for renal care are less known. In this narrative review, we provide an overview of the demonstrated and potential actions of some selected nutrients, nutraceuticals, and xenobiotics on renal health and function. The direct and indirect effects of fiber, protein, fatty acids, curcumin, steviol glycosides, green tea, coffee, nitrates, nitrites, and alcohol on kidney health are reviewed here. In view of functional and personalized nutrition, understanding the renal and systemic effects of dietary components is essential since many chronic conditions, including CKD, are related to systemic dysfunctions such as chronic low-grade inflammation.

KEYWORDS:

CKD; functional nutrition; inflammation; nutraceuticals; nutrients; renal function; xenobiotics

Edited by AlPater

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Potential Micronutrients and Phytochemicals against the Pathogenesis of Chronic Obstructive Pulmonary Disease and Lung Cancer.

Zhai T, Li S, Hu W, Li D, Leng S.

Nutrients. 2018 Jun 25;10(7). pii: E813. doi: 10.3390/nu10070813. Review.

PMID: 29941777

Abstract

Lung cancer and chronic obstructive pulmonary disease have shared etiology, including key etiological changes (e.g., DNA damage and epigenetics change) and lung function impairment. Focusing on those shared targets may help in the prevention of both. Certain micronutrients (vitamins and minerals) and phytochemicals (carotenoids and phenols) have potent antioxidant or methyl-donating properties and thus have received considerable interest. We reviewed recent papers probing into the potential of nutrients with respect to lung function preservation and prevention of lung cancer risk, and suggest several hypothetical intervention patterns. Intakes of vitamins (i.e., A, C, D, E, B12), carotenoids, flavonoids, curcumins, resveratrol, magnesium, and omega-3 fatty acids all show protective effects against lung function loss, some mainly by improving average lung function and others through reducing decline rate. Dietary interventions early in life may help lung function reserve over the lifespan. Protective nutrient interventions among smokers are likely to mitigate the effects of cigarettes on lung health. We also discuss their underlying mechanisms and some possible causes for the inconsistent results in observational studies and supplementation trials. The role of the lung microbiome on lung health and its potential utility in identifying protective nutrients are discussed as well. More prospective cohorts and well-designed clinical trials are needed to promote the transition of individualized nutrient interventions into health policy.

KEYWORDS:

COPD; antioxidants; epigenetics; lung cancer; lung function; phytochemicals; precision medicine; primary prevention; respiratory disease; vitamins

 

PREVEntion and regReSsive Effect of weight-loss and risk factor modification on Atrial Fibrillation: the REVERSE-AF study.

Middeldorp ME, Pathak RK, Meredith M, Mehta AB, Elliott AD, Mahajan R, Twomey D, Gallagher C, Hendriks JML, Linz D, McEvoy RD, Abhayaratna WP, Kalman JM, Lau DH, Sanders P.

Europace. 2018 Jun 14. doi: 10.1093/europace/euy117. [Epub ahead of print]

PMID: 29912366

Abstract

AIMS:

Atrial fibrillation (AF) is a progressive disease. Obesity is associated with progression of AF. This study evaluates the impact of weight and risk factor management (RFM) on progression of the AF.

METHODS AND RESULTS:

As described in the Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up (LEGACY) Study, of 1415 consecutive AF patients, 825 had body mass index ≥ 27 kg/m2 and were offered weight and RFM. After exclusion, 355 were included for analysis. Weight loss was categorized as: Group 1 (<3%), Group 2 (3-9%), and Group 3 (≥10%). Change in AF type was determined by clinical review and 7-day Holter yearly. Atrial fibrillation type was categorized as per the Heart Rhythm Society consensus. There were no differences in baseline characteristic or follow-up duration between groups (P = NS). In Group 1, 41% progressed from paroxysmal to persistent and 26% from persistent to paroxysmal or no AF. In Group 2, 32% progressed from paroxysmal to persistent and 49% reversed from persistent to paroxysmal or no AF. In Group 3, 3% progressed to persistent and 88% reversed from persistent to paroxysmal or no AF (P < 0.001). Increased weight loss was significantly associated with greater AF freedom: 45 (39%) in Group 1, 69 (67%) in Group 2, and 116 (86%) in Group 3 (P ≤ 0.001).

CONCLUSION:

Obesity is associated with progression of the AF disease. This study demonstrates the dynamic relationship between weight/risk factors and AF. Weight-loss management and RFM reverses the type and natural progression of AF.

 

Cardiorespiratory fitness and risk of dementia: a prospective population-based cohort study.

Kurl S, Laukkanen JA, Lonnroos E, Remes AM, Soininen H.

Age Ageing. 2018 Apr 28. doi: 10.1093/ageing/afy060. [Epub ahead of print]

PMID: 29718064

Abstract

Dementia is considered to be one of the major public health problems in light of the ageing population. Little is known about directly measured cardiorespiratory fitness as measured by maximal oxygen uptake and the risk of dementia. Our aim was to examine the relationship of cardiorespiratory fitness, as indicated by maximal oxygen uptake, with subsequent incidence of dementia. This was a population-based cohort study with an average follow-up of 22 (range 0.22-29.8) years from eastern Finland. About 2,031 men with a mean age of 52.8 years of age and no history of dementia or pulmonary disease at baseline participated in the study. Among these men, 208 cases of dementia occurred. Maximal oxygen uptake (ml/kg/min) was measured during exercise testing at baseline. One standard deviation increase in VO2max was associated with a 20% decrease in dementia. Cardiorespiratory fitness was inversely related to the risk of dementia. Men with low cardiorespiratory fitness (VO2max < 23.7 ml/kg/min, lowest quintile) had a 1.92-fold (1.24-2.967, P = 0.003), risk of dementia as compared with men who had high cardiorespiratory fitness (VO2max >36.5 ml/kg/min, highest quintile) after adjusting for age and examination years. In a multivariate model, low cardiorespiratory fitness was associated with a 1.95-fold (1.24-3.05, P = 0.003) risk of dementia. Our findings show that low cardiorespiratory fitness was associated with an increased risk of dementia.

 

Visual and hearing impairments are associated with cognitive decline in older people.

Maharani A, Dawes P, Nazroo J, Tampubolon G, Pendleton N; Sense-Cog WP1 group.

Age Ageing. 2018 Apr 25. doi: 10.1093/ageing/afy061. [Epub ahead of print]

PMID: 29697748

Abstract

INTRODUCTION:

highly prevalagent hearing and vision sensory impairments among older people may contribute to the risk of cognitive decline and pathological impairments including dementia. This study aims to determine whether single and dual sensory impairment (hearing and/or vision) are independently associated with cognitive decline among older adults and to describe cognitive trajectories according to their impairment pattern.

MATERIAL AND METHODS:

we used data from totals of 13,123, 11,417 and 21,265 respondents aged 50+ at baseline from the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE), respectively. We performed growth curve analysis to identify cognitive trajectories, and a joint model was used to deal with attrition problems in longitudinal ageing surveys.

RESULTS:

respondents with a single sensory impairment had lower episodic memory score than those without sensory impairment in HRS (β = -0.15, P < 0.001), ELSA (β= -0.14, P< 0.001) and SHARE (β= -0.26, P < 0.001). The analysis further shows that older adults with dual sensory impairment in HRS (β= -0.25, P < 0.001), ELSA (β= -0.35, P< 0.001) and SHARE (β= -0.68, P < 0.001) remembered fewer words compared with those with no sensory impairment. The stronger associations between sensory impairment and lower episodic memory levels were found in the joint model which accounted for attrition.

CONCLUSIONS:

hearing and/or vision impairments are a marker for the risk of cognitive decline that could inform preventative interventions to maximise cognitive health and longevity. Further studies are needed to investigate how sensory markers could inform strategies to improve cognitive ageing.

 

Lower blood pressure during antihypertensive treatment is associated with higher all-cause mortality and accelerated cognitive decline in the oldest-old-data from the Leiden 85-plus Study.

Streit S, Poortvliet RKE, Gussekloo J.

Age Ageing. 2018 May 8. doi: 10.1093/ageing/afy072. [Epub ahead of print]

PMID: 29741555

https://sci-hub.tw/

Abstract

BACKGROUND:

the appropriateness of lowering systolic blood pressure remains controversial in the oldest-old. We tested whether systolic blood pressure is associated with all-cause mortality and change in cognitive function for patients prescribed antihypertensive treatment and those without treatment.

METHODS:

we studied participants in the population-based Leiden 85-plus cohort study. Baseline systolic blood pressure and use of antihypertensive treatment were predictors; all-cause mortality and change in cognitive function measured using the Mini-Mental State Examination were the outcomes. Grip strength was measured as a proxy for physical frailty. We used Cox proportional hazards and mixed-effects linear regression models to analyse the relationship between systolic blood pressure and both time to death and change in cognitive function. In sensitivity analyses, we excluded deaths within 1 year and restricted analyses to participants without a history of cardiovascular disease.

RESULTS:

of 570 participants, 249 (44%) were prescribed antihypertensive therapy. All-cause mortality was higher in participants with lower blood pressure prescribed antihypertensive treatment (HR 1.29 per 10 mmHg lower systolic blood pressure, 95% CI 1.15-1.46, P < 0.001). Participants taking antihypertensives showed an association between accelerated cognitive decline and lower blood pressure (annual mean change -0.35 points per 10 mmHg lower systolic blood pressure, 95% CI -0.60, -0.11, P = 0.004); decline in cognition was more rapid in those with lower hand grip strength. In participants not prescribed antihypertensive treatment, no significant associations were seen between blood pressure and either mortality or cognitive decline.

CONCLUSIONS:

lower systolic blood pressure in the oldest-old taking antihypertensives was associated with higher mortality and faster decline in cognitive function.

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Associations of serum calcium levels and dietary calcium intake with incident type 2 diabetes over 10 years: the Korean Genome and Epidemiology Study (KoGES).

Kim KN, Oh SY, Hong YC.

Diabetol Metab Syndr. 2018 Jun 19;10:50. doi: 10.1186/s13098-018-0349-y. eCollection 2018.

PMID: 29946367

Abstract

BACKGROUND:

Previous evidence regarding the associations between serum calcium concentrations, dietary calcium intake, and type 2 diabetes (T2D) is limited. We investigated the longitudinal associations of serum calcium levels and dietary calcium intake with T2D development.

METHODS:

This study used data from the Ansung-Ansan cohort, a community-based, prospective cohort that was followed up for 10 years. Cox regression models adjusted for potential confounders were used to evaluate the associations of serum calcium levels (mean, 9.41 mg/dL) and dietary calcium intake (median, 389.59 mg/day) with T2D incidence. Association between dietary calcium intake and serum calcium levels was assessed using linear regression models.

RESULTS:

Albumin-adjusted serum calcium levels were not associated with T2D risk (hazard ratio {HR} = 1.07, 95% confidence interval [CI] 0.96, 1.19, p-value = 0.2333). A one-unit increase in log-transformed, energy-adjusted dietary calcium intake was associated with a decreased risk of T2D (HR = 0.88, 95% CI 0.77, 1.00, p-value = 0.0460) and lower albumin-adjusted serum calcium levels (β = - 0.04, 95% CI - 0.07, - 0.02, p-value = 0.0014). The associations did not differ according to sex (all p-values for interaction > 0.10).

CONCLUSIONS:

Serum calcium levels were not associated with T2D risk, while higher dietary calcium intake was associated with a decreased risk of T2D development. These results have public health implications for predicting and preventing T2D development, as well as providing guidelines for diet and calcium supplementation.

KEYWORDS:

Cohort study; Dietary calcium; Serum calcium; Type 2 diabetes mellitus

 

Association of renal function with bone mineral density and fracture risk in the Longitudinal Aging Study Amsterdam.

Chen H, Lips P, Vervloet MG, van Schoor NM, de Jongh RT.

Osteoporos Int. 2018 Jun 15. doi: 10.1007/s00198-018-4592-8. [Epub ahead of print]

PMID: 29947873

Abstract

Early renal dysfunction is associated with a 38% increased fracture risk in individuals aged 65 years and older. In men but not women, early renal dysfunction is associated with decreased femoral neck bone mineral density (BMD) which can be partially explained by increased parathyroid hormone (PTH) concentrations.

INTRODUCTION:

It is uncertain whether early renal dysfunction is associated with osteoporosis and increased fracture risk. The aim of this study was to determine the relationship of decreased renal function with BMD and fracture risk and the role of PTH therein.

METHODS:

We analyzed data of participants aged 65 years and older from the Longitudinal Aging Study Amsterdam. A 6-year fracture follow-up was obtained in 1477 participants. BMD was measured by dual-energy x-ray absorptiometry (n = 535) and vertebral fractures by lateral spinal radiograph (n = 527) in a subsample at baseline. Glomerular filtration rate (eGFR) was estimated according to the modification of diet in renal disease equation and assessed by the five stages of chronic kidney disease (CKD).

RESULTS:

In men and women, eGFR < 57 ml/min/1.73 m2 (lowest quartile) compared to eGFR > 74 ml/min/1.73 m2 (highest quartile) was associated with a 38% increase in fracture risk after adjustment for relevant confounders [hazard ratio (95%CI): 1.38 (1.17 to 1.61)]. Also, CKD stages 3a and 3b were associated to a 28 and 46% increase in fracture risk, respectively, as compared to CKD stages 1 and 2 together (eGFR > 60 ml/min/1.73 m2) after adjustment for confounders. Renal function was not associated with prevalent vertebral fractures. In men, but not women, lowest quartile of eGFR was related to lower femoral neck BMD as compared to the highest quartile eGFR [unstandardized B (95%CI) - 0.052 g/cm2 (- 0.098 to - 0.006)], after adjustment for relevant confounders. Further adjustment for PTH attenuated this relationship by 27%.

CONCLUSIONS:

In men and women, early decreased renal function (eGFR < 60 ml/min/1.73 m2) was related to increased incident any fracture risk but not with increased prevalence of vertebral fractures. In men, but not women, early renal dysfunction was related to lower femoral neck BMD which could statistically be partially explained by increased PTH concentrations.

KEYWORDS:

Bone mineral density; Fracture; Glomerular filtration rate; Renal function

 

Alterations in dietary sodium intake affects cardiovagal baroreflex sensitivity.

Babcock MC, Brian MS, Watso JC, Edwards DG, Stocker SD, Wenner MM, Farquhar WB.

Am J Physiol Regul Integr Comp Physiol. 2018 Jun 27. doi: 10.1152/ajpregu.00002.2018. [Epub ahead of print]

PMID: 29949407

Abstract

High dietary sodium intake has been linked to alterations in neurally mediated cardiovascular function, but the effects of high sodium on cardiovagal baroreflex sensitivity (cBRS) in healthy adults are unknown.

PURPOSE:

To determine whether high dietary sodium alters cBRS and heart rate variability (HRV), and whether acute intravenous (IV) sodium loading similarly alters cBRS and HRV.

METHODS:

High dietary sodium (300 mmol/day, 7 days) was compared to low sodium (20 mmol/day, 7 days; randomized) in 14 participants (age: 38+/-4 yrs, BMI: 23+/-1 kg/m2, 7 women). Acute sodium loading was achieved via 23-minute IV hypertonic saline (HSI) in 14 participants (age: 22+/-1 yrs, BMI: 23+/-1 kg/m2, 7 women). During both protocols, participants were supine for 5-min while undergoing measurement of beat-to-beat blood pressure (photoplethysmography) and R-R interval (ECG). cBRS was evaluated using the sequence method. RMSSD was used as an index of HRV.

RESULTS:

Serum sodium (137.4+/-0.7 vs. 139.9+/-0.5 mEq/L, =/<0.05), plasma osmolality (285+/-1 vs. 289+/-1 mOsm/kg H2O, =/<0.05), cBRS (18+/-2 vs. 26+/-3 ms/mmHg, =/<0.05), and RMSSD (62+/-6 vs. 79+/-10 ms, =/<0.05) were increased following high sodium diet compared to low sodium. HSI increased serum sodium (138.1+/-0.4 vs. 141.1+/-0.5 mEq/L, =/<0.05) and plasma osmolality (286+/-1 vs. 290+/-1 mOsm/kg H2O, =/<0.05), but did not change cBRS (26+/-5 vs. 25+/-3 ms/mmHg, P=0.73) and RMSSD (63+/-9 vs. 63+/-8 ms, P=0.99).

CONCLUSION:

These data suggest that alterations in dietary sodium intake alter cBRS and HRV, but acute IV sodium loading does not alter these indices of autonomic cardiovascular regulation.

KEYWORDS:

Baroreflex Sensitivity; Cardiovagal; Heart Rate Variability; High Salt Diet; Hypertonic Saline

 

The Influence of Menopausal Hormone Therapy and Potential Lifestyle Interactions in Female Cancer Development-a Population-Based Prospective Study.

Holm M, Olsen A, Kyrø C, Overvad K, Kroman N, Tjønneland A.

Horm Cancer. 2018 Jun 14. doi: 10.1007/s12672-018-0338-5. [Epub ahead of print]

PMID: 29948971

Abstract

The past decades have seen contradictory research results on the health benefits and risks of menopausal hormone therapy (HT). In particular, long-term associations with overall cancer incidence and the potential interplay with other lifestyle factors remain undetermined. In a population-based prospective cohort, 29,152 women aged 50-64 years at entry (1993-1997) were followed through 2013 for incidence of cancer (99% complete follow-up). Cox' proportional hazards models were used to estimate cancer incidence according to baseline HT alone and in combination with lifestyle factors including alcohol intake, BMI, physical activity, diet, and smoking. Among 5484 women diagnosed with cancer, baseline HT was associated with an overall higher risk of cancer (HR 1.28; 95%CI, 1.21-1.36)-in particular, a higher risk of breast (HR 1.77; 95%CI, 1.61-1.95), ovarian (HR 1.68; 95%CI, 1.26-2.26), and endometrial (HR 1.86; 95%CI, 1.45-2.37) cancer. Combination with other lifestyle risk factors largely displayed additive associations. The risk of colorectal cancer was significantly lower (HR 0.79; 95%CI, 0.66-0.95). However, in the interaction analysis, only "healthy" subgroups of women using HT had a lower risk of colorectal cancer. With an overall higher risk of cancer among women on HT, this study underlined the importance of considering all female cancer risks in menopausal treatment guidelines. The largely additive associations between HT and the investigated lifestyle factors support the notion that high levels of hormones in itself play an important etiological role in female reproductive cancers, whereas the possible protective impact in colorectal cancer might be limited to women with an otherwise healthy lifestyle.

 

Plant versus animal based diets and insulin resistance, prediabetes and type 2 diabetes: the Rotterdam Study.

Chen Z, Zuurmond MG, van der Schaft N, Nano J, Wijnhoven HAH, Ikram MA, Franco OH, Voortman T.

Eur J Epidemiol. 2018 Jun 8. doi: 10.1007/s10654-018-0414-8. [Epub ahead of print]

PMID: 29948369

Abstract

Vegan or vegetarian diets have been suggested to reduce type 2 diabetes (T2D) risk. However, not much is known on whether variation in the degree of having a plant-based versus animal-based diet may be beneficial for prevention of T2D. We aimed to investigate whether level of adherence to a diet high in plant-based foods and low in animal-based foods is associated with insulin resistance, prediabetes, and T2D. Our analysis included 6798 participants (62.7 ± 7.8 years) from the Rotterdam Study (RS), a prospective population-based cohort in the Netherlands. Dietary intake data were collected with food-frequency questionnaires at baseline of three sub-cohorts of RS (RS-I-1: 1989-1993, RS-II-1: 2000-2001, RS-III-1: 2006-2008). We constructed a continuous plant-based dietary index (range 0-92) assessing adherence to a plant-based versus animal-based diet. Insulin resistance at baseline and follow-up was assessed using homeostasis model assessment of insulin resistance (HOMA-IR). Prediabetes and T2D were collected from general practitioners' records, pharmacies' databases, and follow-up examinations in our research center until 2012. We used multivariable linear mixed models to examine association of the index with longitudinal HOMA-IR, and multivariable Cox proportional-hazards regression models to examine associations of the index with risk of prediabetes and T2D. During median 5.7, and 7.3 years of follow-up, we documented 928 prediabetes cases and 642 T2D cases. After adjusting for sociodemographic and lifestyle factors, a higher score on the plant-based dietary index was associated with lower insulin resistance (per 10 units higher score: β = -0.09; 95% CI: - 0.10; - 0.08), lower prediabetes risk (HR = 0.89; 95% CI: 0.81; 0.98), and lower T2D risk [hr 0.82 (0.73; 0.92)]. After additional adjustment for BMI, associations attenuated and remained statistically significant for longitudinal insulin resistance [β = -0.05 (- 0.06; - 0.04)] and T2D risk [hr 0.87 (0.79; 0.99)], but no longer for prediabetes risk [hr 0.93 (0.85; 1.03)]. In conclusion, a more plant-based and less animal-based diet may lower risk of insulin resistance, prediabetes and T2D. These findings strengthen recent dietary recommendations to adopt a more plant-based diet.

KEYWORDS:

Cohort study; Epidemiology; Insulin resistance; Plant-based diet; Prediabetes; Type 2 diabetes

 

Prolonged Leisure-Time Spent Sitting in Relation to Cause-specific Mortality in a Large U.S. Cohort.

Patel AV, Maliniak ML, Rees-Punia E, Matthews CE, Gapstur SM.

Am J Epidemiol. 2018 Jun 26. doi: 10.1093/aje/kwy125. [Epub ahead of print]

PMID: 29947736

https://sci-hub.tw/https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwy125/5045572

Abstract

The majority of leisure-time is spent in sedentary behaviors such as television viewing. Studies have documented that prolonged leisure-time sitting is associated with higher risk of total, cardiovascular disease, cancer, and "all other causes" of mortality, but few have examined the "other" causes of death in detail. To examine associations of leisure-time sitting with risk of specific causes of death, data were analyzed from the CPS-II Nutrition Cohort, a prospective U.S. cohort including 127,554 men and women who were free of major chronic disease at study entry and among whom 48,784 died during 21 years of follow-up (1993-2014; median=20.3 years, IQR=4.6 years). After multivariable adjustment, prolonged leisure-time sitting (6+ vs <3 hours/day) was associated with higher risk of all-cause, cardiovascular disease (including coronary heart disease and stroke-specific mortality), cancer, diabetes, kidney disease, suicide, chronic obstructive pulmonary disease, pneumonitis due to solids and liquids, liver and other digestive disease, Parkinson's disease, Alzheimer's disease, nervous disorders, and musculoskeletal disorders mortality. These findings provide additional evidence for associations between a broad range of mortality outcomes and prolonged sitting time. Given the pervasive nature of sitting in contemporary lifestyle, this study further supports that encouraging individuals to reduce sedentary time may provide health benefits.

 

Resveratrol Induces Brain Resilience Against Alzheimer Neurodegeneration Through Proteostasis Enhancement.

Corpas R, Griñán-Ferré C, Rodríguez-Farré E, Pallàs M, Sanfeliu C.

Mol Neurobiol. 2018 Jun 13. doi: 10.1007/s12035-018-1157-y. [Epub ahead of print]

PMID: 29948950

Abstract

Resveratrol is a natural compound that mimics the antioxidant and antiaging effects of caloric restriction, mainly mediated through SIRT1, a deacetylase that induces longevity and neuroprotection. We aimed to analyze the effects of resveratrol on the brain status of control non-transgenic (NoTg) and AD transgenic (3xTg-AD) mice to discern the mechanisms involved in a potential inducement of resilience against age-related neurodegeneration and Alzheimer's disease (AD). Mice were fed with a diet supplemented with 100 mg/kg of resveratrol from 2 months of age during 10 months. Resveratrol administration induced complete protection against memory loss and brain pathology in 3xTg-AD mice, and also induced cognitive enhancement in healthy NoTg mice. Resveratrol improved exploration and reduced anxiety in both mouse strains, indicative of well-being. Resveratrol reduced the presence of Aβ and p-tau pathology in the hippocampus of the 3xTg-AD mouse. Proteostasis analysis showed the following in both NoTg and 3xTg-AD mice: (i) increased levels of the amyloid-degrading enzyme neprilysin, (ii) reduction of the amyloidogenic secretase BACE1, and (iii) increase of proteasome protein levels and enhancement of proteasome activity. Resveratrol also increased AMPK protein levels, then upregulating the SIRT1 pathway, as shown by the activation of PGC-1α and CREB in both mice, resulting in further beneficial changes. Our data demonstrated that resveratrol induces cognitive enhancement and neuroprotection against amyloid and tau pathologies. Improvement of proteostasis by resveratrol, in both healthy and AD mice, suggests that it is a mechanism of brain resilience and defense against neurodegeneration caused by the accumulation of aberrant proteins.

KEYWORDS:

3xTg-AD; Neuroprotection; Proteasome; Resveratrol; SIRT1

Edited by AlPater

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https://www.nejm.org/doi/pdf/10.1056/NEJMoa1716435

 

Oral Intake of Low-Molecular-Weight Collagen Peptide Improves Hydration, Elasticity, and Wrinkling in Human Skin: A Randomized, Double-Blind, Placebo-Controlled Study.

Kim DU, Chung HC, Choi J, Sakai Y, Lee BY.

Nutrients. 2018 Jun 26;10(7). pii: E826. doi: 10.3390/nu10070826.

PMID: 29949889

http://www.mdpi.com/2072-6643/10/7/826/htm

Abstract

Collagen-peptide supplementation could be an effective remedy to improve hydration, elasticity, and wrinkling in human skin. The aim of this study was to conduct a double-blind, randomized, placebo-controlled trial to clinically evaluate the effect on human skin hydration, wrinkling, and elasticity of Low-molecular-weight Collagen peptide (LMWCP) with a tripetide (Gly-X-Y) content >15% including 3% Gly-Pro-Hyp. Individuals (n = 64) were randomly assigned to receive either placebo or 1000 mg of LMWCP once daily for 12 weeks. Parameters of skin hydration, wrinkling, and elasticity were assessed at baseline and after 6 weeks and 12 weeks. Compared with the placebo group, skin-hydration values were significantly higher in the LMWCP group after 6 weeks and 12 weeks. After 12 weeks in the LMWCP group, visual assessment score and three parameters of skin wrinkling were significantly improved compared with the placebo group. In case of skin elasticity, one parameter out of three was significantly improved in the LMWCP group from the baseline after 12 weeks, while, compared with the placebo group, two parameters out of three in the LMWCP group were higher with significance after 12 weeks. In terms of the safety of LMWCP, none of the subjects presented adverse symptoms related to the test material during the study period. These results suggest that LMWCP can be used as a health functional food ingredient to improve human skin hydration, elasticity, and wrinkling.

KEYWORDS:

collagen hydrolysate; collagen tripeptide; fish collagen; low-molecular-weight collagen peptide; photoaging; skin elasticity; skin hydration; skin wrinkling; type I collagen

 

Nut consumption and the risk of oesophageal squamous cell carcinoma in the Golestan Cohort Study.

Hashemian M, Murphy G, Etemadi A, Poustchi H, Sharafkhah M, Kamangar F, Pourshams A, Malekshah AF, Khoshnia M, Gharavi A, Hekmatdoost A, Brennan PJ, Boffetta P, Dawsey SM, Abnet CC, Malekzadeh R.

Br J Cancer. 2018 Jun 28. doi: 10.1038/s41416-018-0148-0. [Epub ahead of print]

PMID: 29950612

Abstract

BACKGROUND:

Nut consumption has been inversely associated with gastric cancer incidence in US-based studies, but not with oesophageal cancer. However, there is aetiologic heterogeneity, among oesophageal squamous cell carcinoma (ESCC) cases in low-risk vs. high-risk populations. The objective of this study was to evaluate the association between nut consumption and risk of ESCC in a high-risk population.

METHODS:

The Golestan Cohort Study enroled 50,045 participants in Northeastern Iran, between 2004 and 2008. Intake of peanuts, walnuts and mixed nuts (including seeds) were assessed using a validated food frequency questionnaire at baseline. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals for subsequent ESCC adjusted for potential confounders. Non-consumers of nuts were used as the reference category and the consumers were categorised into tertiles.

RESULTS:

We accrued 280 incident ESCC cases during 337,983 person-years of follow up. Individuals in the highest tertiles of total nut consumption, and mixed nut consumption were significantly associated with lower risk of developing ESCC compared to non-consumers (HR = 0.60, 95% CI = 0.39-0.93, p-trend = 0.02, and HR = 0.52, 95% CI = 0.32-0.84, p trend = 0.002, respectively).

CONCLUSIONS:

We found a statistically significant inverse association between total nut consumption and the risk of ESCC in this high-risk population.

 

Fish Intake and Death From Pulmonary Embolisms Among Japanese Men and Women - The Japan Collaborative Cohort (JACC) Study.

Ohira T, Iso H, Yamagishi K, Tamakoshi A; JACC Study Group.

Circ J. 2018 Jun 27. doi: 10.1253/circj.CJ-18-0040. [Epub ahead of print]

PMID: 29952347

Abstract

BACKGROUND:

Numerous studies have reported the association of cardiovascular risk factors with pulmonary embolism (PE), but the association of dietary factors, especially fish intake, with the risk of PE has not been fully established.

Methods and Results:

Using a prospective design, we studied the risk of PE mortality in relation to fish intake in 90,791 community-dwelling men and women in Japan aged 40-79 years. The hazard ratios (HRs) and 95% confidence intervals (CIs) for PE death were estimated using the Cox proportional hazards model. Compared with participants in the lowest fresh fish intake group (<1 time/month), the HRs (95% CIs) for PE death for those in the other intake groups were 0.35 (0.08-1.59) for 1-2 times/month, 0.19 (0.05-0.69) for 1-2 times/week, 0.20 (0.06-0.74) for 3-4 times/week, and 0.18 (0.05-0.66) for fish intake every day. In addition to these findings, compared with the participants in the lowest 10% of ω3 polyunsaturated fatty acid intake, those in the other groups had a 60-76% lower risk of PE death.

CONCLUSIONS:

Fresh fish intake, even 1-2 times/week, is associated with a lower risk of death from PE among Japanese men and women.

KEYWORDS:

Diet; Epidemiology; Prospective cohort study; Risk factors; Venous thromboembolism

 

Long-term yogurt consumption and risk of incident hypertension in adults.

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

J Hypertens. 2018 Aug;36(8):1671-1679. doi: 10.1097/HJH.0000000000001737.

PMID: 29952852

Abstract

OBJECTIVE:

To evaluate the relation between yogurt consumption as well as cheese, milk, and total dairy, and high blood pressure (HBP) in two Nurses' Health Study cohorts (NHS, n = 69 298), NHS II (n = 84 368) and the Health Professionals Follow-Up Study (HPFS, n = 30 512).

METHODS:

NHS, NHS II, and HPFS participants were followed for incident HBP for up to 30, 20, and 24 years, respectively. Hazard ratios were calculated using time-dependent multivariate-adjusted Cox proportional hazards models. Pooled risk estimates were derived from fixed effects meta-analyses.

RESULTS:

Participants consuming at least five servings per week (vs. <1 serving per month) of yogurt in NHS, NHS II, and HPFS had 19% (95% CI 0.75-0.87), 17% (95% CI 0.77-0.90), and 6% (95% CI 0.83-1.07) lower HBP risks, respectively. In pooled analyses of these cohorts, higher yogurt consumption was linked with 16% (95% CI 0.80-0.88) lower HBP risk; higher total dairy (3 to <6 vs. <0.5 servings/day), milk (2 to <6/day vs. <4/week) and cheese (1 to 4/day vs. <1/week) were associated with 16% (95% CI 0.81-0.87), 12% (95% CI 0.86-0.90), and 6% (95% CI 0.90-0.97) lower HBP risks, respectively. After controlling for BMI as a possible causal intermediate, total dairy, yogurt, milk, and cheese were associated with 13, 10, 8, and 8% lower HBP risks, respectively. The combination of higher yogurt intake and higher DASH ('Dietary Approaches to Stop Hypertension') diet scores was associated with 30% (95% CI 0.66-0.75) lower HBP risk compared with lower levels of both factors.

CONCLUSION:

Higher total dairy intake, especially in the form of yogurt, was associated with lower risk of incident HBP in middle-aged and older adult men and women.

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