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Role of androgens in energy metabolism affecting on body composition, metabolic syndrome, type 2 diabetes, cardiovascular disease, and longevity: lessons from a meta-analysis and rodent studies.

Harada N.

Biosci Biotechnol Biochem. 2018 Jun 29:1-16. doi: 10.1080/09168451.2018.1490172. [Epub ahead of print]

PMID: 29957125

https://sci-hub.tw/

Abstract

Testosterone is a sex hormone produced by testicular Leydig cells in males. Blood testosterone concentrations increase at three time-periods in male life-fetal, neonatal (which can be separated into newborn and infant periods), and pubertal stages. After peaking in the early 20s, the blood bioactive testosterone level declines by 1-2% each year. It is increasingly apparent that a low testosterone level impairs general physical and mental health in men. Here, this review summarizes recent systematic reviews and meta-analyses of epidemiological studies in males (including cross-sectional, longitudinal, and androgen deprivation studies, and randomized controlled testosterone replacement trials) in relation to testosterone and obesity, body composition, metabolic syndrome, type 2 diabetes, cardiovascular disease, and longevity. Furthermore, underlying mechanisms are discussed using data from rodent studies involving castration or androgen receptor knockout. This review provides an update understanding of the role of testosterone in energy metabolism.

Abbreviations AR: androgen receptor; CV: cardiovascular; FDA: US Food and Drug Administration; HFD: high-fat diet; KO: knockout; MetS: metabolic syndrome; RCT: randomized controlled trial; SHBG: sex hormone binding globulin; SRMA: systematic review and meta-analysis; TRT: testosterone replacement therapy; T2DM:type 2 diabetes mellitus.

KEYWORDS:

Testosterone; androgen; cardiovascular disease; metabolic syndrome and type 2 diabetes; systematic review and meta-analysis

 

Increased plasma trimethylamine-N-oxide is associated with incident atrial fibrillation.

Svingen GFT, Zuo H, Ueland PM, Seifert R, Løland KH, Pedersen ER, Schuster PM, Karlsson T, Tell GS, Schartum-Hansen H, Olset H, Svenningsson M, Strand E, Nilsen DW, Nordrehaug JE, Dhar I, Nygård O.

Int J Cardiol. 2018 Sep 15;267:100-106. doi: 10.1016/j.ijcard.2018.04.128.

PMID: 29957250

Abstract

BACKGROUND:

Plasma trimethylamine-N-oxide (TMAO) is associated with cardiovascular disease; however specific relationships with cardiac arrhythmias are unknown. We evaluated the association between plasma TMAO and incident atrial fibrillation (AF).

METHODS:

Risk associations were explored among 3797 patients with suspected stable angina in the Western Norway Coronary Angiography Cohort (WECAC) and verified in 3143 elderly participants in the community-based Hordaland Health Study (HUSK). Information on endpoints was obtained from nationwide registries.

RESULTS:

Median follow-up was 7.3 and 10.8 years in the WECAC and HUSK cohorts, respectively, and 412 (10.9%) and 484 (15.4%) subjects were registered with incident AF. The age and gender adjusted HRs were 1.16, 95% CI 1.05-1.28 and 1.10, 95% CI 1.004-1.19 per 1 SD increase in log-transformed plasma TMAO. Adjusting for hypertension, BMI, smoking, diabetes, or intake of total choline, a TMAO precursor, did not materially influence the risk associations. Among patients in WECAC, further extensive adjustment for other AF risk factors yielded similar results. Adding TMAO to traditional AF risk factors (age, gender, hypertension, BMI, smoking and diabetes) yielded a continuous net reclassification improvement of 0.108, 95% CI 0.015-0.202 and 0.139, 95% CI 0.042-0.235.

CONCLUSIONS:

Plasma TMAO was associated with and improved reclassification of incident AF in two independent Norwegian cohorts with long-term follow-up. The relationship was independent of traditional AF risk factors, as well as of dietary choline intake. Our findings motivate further studies to explore endogenous metabolic factors influencing the relationship between TMAO and cardiovascular disease.

KEYWORDS:

Atrial fibrillation; Biomarker; Cardiovascular disease risk factors; Choline; Trimethylamine-N-oxide

 

Diet Soda and Sugar-Sweetened Soda Consumption in Relation to Incident Diabetes in the Northern Manhattan Study.

Gardener H, Moon YP, Rundek T, Elkind MSV, Sacco RL.

Curr Dev Nutr. 2018 Jan 30;2(5):nzy008. doi: 10.1093/cdn/nzy008. eCollection 2018 May.

PMID: 29955723

https://watermark.silverchair.com/nzy008.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAZ4wggGaBgkqhkiG9w0BBwagggGLMIIBhwIBADCCAYAGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMC7yPLKeyT7PsaJ0PAgEQgIIBUT_f9MEIDQzI0LyB2NDv_e13HfnH_SwmY0H0-EZPqVgpzx-1WVf1nBX5wQoEwwbWblVsMfifIF8c0JO2nuU4aIYj3wT3j7h6NrKnC1Lkm3t5_jBcjcbFNXUPwLKNVpGreYUBcdDR-2ChhRFkIOEjALrd_TJxC1oWm-739j7ad2i6YX_WJm7IGV61Hp3wpnFGnJg_osVILGVlmivMSFhBak_l-By1PcYM4qnrXrvcOPEKbgj-1O071aQVYIXYxmy72yXc8yjXg47rMmPOHoegEqH8rWWVv4v-DWtVnnBu8T0QUNrM1FJmqHVM6IzojqavilgLZgAGe-vkleMbe9Qgfo6DTk0fP1K9q9A_E_QDx_YiwaEUF2Cv6JZmIId6glY2DbjcmJEkElhaH-teKyeWsPzya-b08cU1ayUkT3zun7mvdeqLPWmiKO-wf9VRx_uBm78

Abstract

BACKGROUND:

Artificially (diet) and sugar-sweetened (regular) soda consumption have been associated with an increased risk of diabetes, but the literature on diet soda is inconsistent and the mechanisms unclear.

OBJECTIVE:

We examined the relation between diet soda and regular soda consumption with the risk of incident diabetes in a longitudinal multiethnic population-based cohort.

METHODS:

The study population included 2019 participants (mean ± SD age: 69 ± 10 y; 64% women; 23% white, 22% black, 53% Hispanic) in the Northern Manhattan Study who were free of diabetes and stroke at baseline. Soda consumption was assessed by a food-frequency questionnaire at baseline and examined continuously and categorically (<1/mo: sugar-sweetened = 908, diet = 1615; 1/mo-6/wk: sugar-sweetened = 830, diet = 298; daily: sugar-sweetened = 281, diet = 106). Weibull regression models were used to estimate the associations between soda consumption and incident diabetes, adjusting for demographics and vascular risk factors including body mass index (BMI) and calorie consumption.

RESULTS:

During a mean ± SD follow-up of 11 ± 5 y, 368 participants developed diabetes. Sugar-sweetened soda was positively associated with incident diabetes (per soda per day HR = 1.15, 95% CI: 1.02, 1.31). The observed association between diet soda and elevated risk of diabetes was largely explained by BMI at the time of diet assessment, though the association remained strong and independent of BMI among those who were overweight or obese (daily compared to <1/mo: HR = 1.63, 95% CI: 1.04, 2.55).

CONCLUSIONS:

This study supports the importance of sugar-sweetened beverage consumption in the diabetes epidemic. However, the results support previous studies suggesting that switching to artificially sweetened diet beverages may not lower the risk of diabetes, as diet soda consumption cannot be ruled out as an independent diabetes risk factor.

KEYWORDS:

artificially sweetened beverages; diabetes; diet; soda; sugar-sweetened beverages

 

Phytic acid improves intestinal mucosal barrier damage and reduces serum levels of proinflammatory cytokines in a 1,2-dimethylhydrazine-induced rat colorectal cancer model.

Liu C, Chen C, Yang F, Li X, Cheng L, Song Y.

Br J Nutr. 2018 Jul;120(2):121-130. doi: 10.1017/S0007114518001290.

PMID: 29947321

Abstract

Phytic acid (PA) has been demonstrated to have a potent anticarcinogenic activity against colorectal cancer (CRC). Defects of the intestinal mucosal barrier and inflammation processes are involved in the development and progression of CRC. In the present study, we evaluated the effect of PA on the intestinal mucosal barrier and proinflammatory cytokines. After a 1-week acclimatisation period, sixty Wistar male rats were divided into the following five groups, with twelve rats per group: the control group (CG), model group (MG), low-PA-dose group (0·25 g/kg per d), middle-PA-dose group (0·5 g/kg per d), and high-PA-dose group (1 g/kg per d). 1,2-Dimethylhydrazine (DMH) at a dosage of 30 mg/kg of body weight was injected weekly to induce CRC for 18 weeks. We examined the expression of genes related to the intestinal mucosal barrier in the model. The results demonstrated that tumour incidence was decreased following PA treatment. The mRNA and protein expression of mucin 2 (MUC2), trefoil factor 3 (TFF3) and E-cadherin in the MG were significantly lower than those in the CG (P<0·05). The mRNA and protein expression of claudin-1 in the MG were significantly higher than those in the CG (P<0·05). PA elevated the mRNA and protein expression of MUC2, TFF3 and E-cadherin, and diminished the mRNA and protein expression of claudin-1. Furthermore, PA decreased serum levels of proinflammatory cytokines, which included TNF-α, IL-1β and IL-6. In conclusion, this study suggests that PA has favourable effects on the intestinal mucosal barrier and may reduce serum proinflammatory cytokine levels.

KEYWORDS:

CG control group; CRC colorectal cancer; D-LA D-lactate; DMH 1; HPG high-phytic acid-dose group; LPG low-phytic acid-dose group; LPS lipopolysaccharide; MG model group; MPG middle-phytic acid-dose group; MUC2 mucin 2; PA phytic acid; TFF3 trefoil factor 3; 2-dimethylhydrazine; Colorectal cancer; Intestinal mucosal barrier; Phytic acid; Proinflammatory cytokines

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Dairy products and chronic kidney disease: Protective or harmful? A systematic review of prospective cohort studies.

Eslami O, Shidfar F.

Nutrition. 2018 Mar 29;55-56:21-28. doi: 10.1016/j.nut.2018.03.047. [Epub ahead of print] Review.

PMID: 29960152

https://sci-hub.tw/10.1016/j.nut.2018.03.047

Abstract

OBJECTIVE:

Evidence on the relationship between food sources of protein and progressive decline in renal function in the general population is still controversial. Among the protein-rich foods, dairy products have gained a lot of attention in research on the prevention of metabolic disorders. This systemic review attempted to summarize the findings of prospective cohort studies on the relationship between dairy foods and incident chronic kidney disease (CKD) in the general population.

METHODS:

The PubMed, Embase, Scopus, and Web of Science databases were searched from inception up to January 2018 with no restriction on the language of publication. Studies conducted in the general population with consumption of dairy foods as the exposure of interest and with incident CKD and/or decline in renal function as the study outcome were eligible for inclusion in the review.

RESULTS:

Of the 391 articles that were extracted through database searching, 7 were included in the review. Of the seven studies, five reported a protective association for dairy consumption, particularly low-fat dairy, against incident CKD or rapid decline in renal function; however, two studies did not find such an association.

CONCLUSION:

Despite the limited studies on this topic, findings from the available reports are generally in favor of a positive association between dairy and renal health in the general population. However, further studies are needed to replicate this finding and to determine whether this relationship could be influenced by the fat content and/or the dairy subtypes.

KEYWORDS:

Albuminuria; Chronic kidney disease; Dairy products; Glomerular filtration rate; Low-protein diet

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Female reproductive factors and risk of all-cause and cause-specific mortality among women: The Japan Public Health Center-based Prospective Study (JPHC study).

Otsuki S, Saito E, Sawada N, Abe SK, Hidaka A, Yamaji T, Shimazu T, Goto A, Iwasaki M, Iso H, Mizoue T, Shibuya K, Inoue M, Tsugane S; JPHC Study Group.

Ann Epidemiol. 2018 Jun 15. pii: S1047-2797(17)30917-1. doi: 10.1016/j.annepidem.2018.06.001. [Epub ahead of print]

PMID: 29960824

https://sci-hub.tw/

Abstract

PURPOSE:

We investigated the association between reproductive history and mortality from all and major causes among Japanese women.

METHODS:

A large-scale population-based cohort study in Japan included 40,149 eligible women aged 40-69 years in 1990-1994. A total of 4788 deaths were reported during follow-up (average 20.9 years). A Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CI) for all-cause and major causes of mortality, adjusting for potential confounders.

RESULTS:

Inverse associations with all-cause mortality were found in parous women (0.74 [0.67-0.82]), women with two or three births compared with a single birth (2 births: 0.88 [0.78-0.99]; 3 births: 0.83 [0.74-0.94]), parous women who breastfed (0.81 [0.75-0.87]), women who were older at menopause (0.88 [0.80-0.97]; p-trend: <0.01), and women who had a longer fertility span (0.85 [0.76-0.95]; p-trend: <0.01). A positive association was seen between all-cause mortality and later age at first birth (≥30 years) than early childbearing (≤22 years).

CONCLUSIONS:

Our study suggests that parous, two or three births, breastfeeding, late age at menopause, and longer reproductive span are associated with lower risk of all-cause of mortality.

KEYWORDS:

Breastfeeding; Cohort Studies; Japan; Menarche; Menopause; Mortality; Parity; Prospective Studies; Reproductive factors

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Prevalence of Morbidity at Extreme Old Age in Germany: An Observational Study Using Health Claims Data.

Doblhammer G, Barth A.

J Am Geriatr Soc. 2018 Jul 2. doi: 10.1111/jgs.15460. [Epub ahead of print]

PMID: 29963696

Abstract

We assessed the prevalence of morbidity in long-lived individuals according to age and age at death and explored the association between dementia and other diseases and surviving to age 90 and 100. Using health claims data from the largest German health insurer from 2004 to 2013, we followed birth cohorts from 1908 to 1913 from age 95 until death or survival to age 100 (n=2,865) and compared them with birth cohorts from 1918 to 1923 and their survival from age 85 to age 90 (n=17,013). We observed their exact date of death and main categories of morbidity based on International Classification of Diseases, Tenth Revision, diagnoses. For all diseases studied, when differentiated according to age at death, prevalence continued to increase with age. Nonagenarians and centenarians had significantly lower disease prevalence at each age. Dementia was associated with the highest risk of dying before becoming a centenarian (hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.50-1.78), followed closely by the residual category other chronic heart disease (HR=1.42, 95% CI=1.30-1.56). Results were even stronger for the younger cohort. Our study shows that exceptionally long-lived individuals are different in terms of good health. Survival at these high ages depends primarily on the absence of dementia and chronic heart disease, with acute heart disease and pneumonia playing important roles as diseases leading directly to death.

KEYWORDS:

centenarians; dementia; health conditions; nonagenarians; survival

 

New guidelines with few takers: will the new American guidelines ever be accepted?

Nadar SK, Stowasser M.

J Hum Hypertens. 2018 Jun;32(6):387-389. doi: 10.1038/s41371-018-0049-y. Epub 2018 Mar 1. No abstract available.

PMID: 29497151

https://www.nature.com/articles/s41371-018-0049-y?WT.ec_id=JHH-201807&spMailingID=56917223&spUserID=MTc2MzA2Mjk5OAS2&spJobID=1440175938&spReportId=MTQ0MDE3NTkzOAS2

"The headline grabbing feature of this new guideline is the lower blood pressure (BP) threshold. Here, the ACC/AHA call a BP above 120/80 mm Hg as elevated (previously referred to pre-hypertension) and define those below 120/80 mm Hg as being normal. The JNC-7 and the European society of cardiology guidelines in 2013 [4] defined normal BP as those below 130/80 mm Hg."

"To conclude it is fair to say that the main criticisms of the new guidelines are mainly directed at the practical issues regarding the new BP thresholds rather than the new thresholds themselves. Health systems would have to come up with ways and means to tackle the increased burden. At the end, these are only guidelines and serve the purpose they are meant to do, which is to guide our treatment. Having generated so much publicity they will bring hypertension to the forefront of the discussion of any community health planning and make people more aware that lower is better. For now, however, we suspect there will not be a major worldwide rush, or indeed not even an American rush to try to bring BPs down to the new recommended levels."

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Role for fatty acid amide hydrolase (FAAH) in the leptin-mediated effects on feeding and energy balance.

Balsevich G, Sticht M, Bowles NP, Singh A, Lee TTY, Li Z, Chelikani PK, Lee FS, Borgland SL, Hillard CJ, McEwen BS, Hill MN.

Proc Natl Acad Sci U S A. 2018 Jul 2. pii: 201802251. doi: 10.1073/pnas.1802251115. [Epub ahead of print]

PMID: 29967158

Abstract

Endocannabinoid signaling regulates feeding and metabolic processes and has been linked to obesity development. Several hormonal signals, such as glucocorticoids and ghrelin, regulate feeding and metabolism by engaging the endocannabinoid system. Similarly, studies have suggested that leptin interacts with the endocannabinoid system, yet the mechanism and functional relevance of this interaction remain elusive. Therefore, we explored the interaction between leptin and endocannabinoid signaling with a focus on fatty acid amide hydrolase (FAAH), the primary degradative enzyme for the endocannabinoid N-arachidonoylethanolamine (anandamide; AEA). Mice deficient in leptin exhibited elevated hypothalamic AEA levels and reductions in FAAH activity while leptin administration to WT mice reduced AEA content and increased FAAH activity. Following high fat diet exposure, mice developed resistance to the effects of leptin administration on hypothalamic AEA content and FAAH activity. At a functional level, pharmacological inhibition of FAAH was sufficient to prevent leptin-mediated effects on body weight and food intake. Using a novel knock-in mouse model recapitulating a common human polymorphism (FAAH C385A; rs324420), which reduces FAAH activity, we investigated whether human genetic variance in FAAH affects leptin sensitivity. While WT (CC) mice were sensitive to leptin-induced reductions in food intake and body weight gain, low-expressing FAAH (AA) mice were unresponsive. These data demonstrate that FAAH activity is required for leptin's hypophagic effects and, at a translational level, suggest that a genetic variant in the FAAH gene contributes to differences in leptin sensitivity in human populations.

KEYWORDS:

endocannabinoids; fatty acid amide hydrolase; feeding; leptin

 

Immunity and longevity.

Csaba G.

Acta Microbiol Immunol Hung. 2018 Jul 3:1-17. doi: 10.1556/030.65.2018.029. [Epub ahead of print]

PMID: 29968490

Abstract

The role of immune system is to protect the organism from the not built-in program-like alterations inside and against the agents penetrating from outside (bacteria, viruses, and protozoa). These functions were developed and formed during the evolution. Considering these functions, the immune system promotes the lengthening of lifespan and helps longevity. However, some immune functions have been conveyed by men to medical tools (e.g., pharmaceuticals, antibiotics, and prevention), especially in our modern age, which help the struggle against microbes, but evolutionarily weaken the immune system. Aging is a gradual slow attrition by autoimmunity, directed by the thymus and regulated by the central nervous system and pineal gland. Considering this, thymus could be a pacemaker of aging. The remodeling of the immune system, which can be observed in elderly people and centenarians, is probably not a cause of aging, but a consequence of it, which helps to suit immunity to the requirements. Oxidative stress also helps the attrition of the immune cells and antioxidants help to prolong lifespan. There are gender differences in the aging of the immune system as well as in the longevity. There is an advantage for women in both cases. This can be explained by hormonal differences (estrogens positively influences both processes); however, social factors are also not excluded. The endocrine disruptor chemicals act similar to estrogens, like stimulating or suppressing immunity and provoking autoimmunity; however, their role in longevity is controversial. There are some drugs (rapamycin, metformin, and selegiline) and antioxidants (as vitamins C and E) that prolong lifespan and also improve immunity. It is difficult to declare that longevity is exclusively dependent on the state of the immune system; however, there is a parallelism between the state of immune system and lifespan. It seems likely that there is not a real decline of immunity during aging, but there is a remodeling of the system according to the claims of senescence. This is manifested in the remaining (sometimes stronger) function of memory cells in contrast to the production and number of the new antigen-reactive naive T-cells.

KEYWORDS:

autoimmunity; endocrine disruptors; hormonal imprinting; immune system; lifespan; thymus

 

Prospective Associations between Single Foods, Alzheimer's Dementia and Memory Decline in the Elderly.

Fischer K, Melo van Lent D, Wolfsgruber S, Weinhold L, Kleineidam L, Bickel H, Scherer M, Eisele M, van den Bussche H, Wiese B, König HH, Weyerer S, Pentzek M, Röhr S, Maier W, Jessen F, Schmid M, Riedel-Heller SG, Wagner M.

Nutrients. 2018 Jun 29;10(7). pii: E852. doi: 10.3390/nu10070852.

PMID: 29966314

Abstract

Background: Evidence whether single “cognitive health” foods could prevent cognitive decline is limited. We investigated whether dietary intake of red wine, white wine, coffee, green tea, olive oil, fresh fish, fruits and vegetables, red meat and sausages, assessed by a single-food-questionnaire, would be associated with either incident Alzheimer’s dementia (AD) or verbal memory decline. Methods: Participants aged 75+ of the German Study on Aging, Cognition and Dementia in Primary Care Patients (AgeCoDe) cohort were regularly followed over 10 years (n = 2622; n = 418 incident AD cases). Multivariable-adjusted joint modeling of repeated-measures and survival analysis was used, taking gender and Apolipoprotein E4 (APOE ε4) genotype into account as possible effect modifiers. Results: Only higher red wine intake was associated with a lower incidence of AD (HR = 0.92; P = 0.045). Interestingly, this was true only for men (HR = 0.82; P < 0.001), while in women higher red wine intake was associated with a higher incidence of AD (HR = 1.15; P = 0.044), and higher white wine intake with a more pronounced memory decline over time (HR = −0.13; P = 0.052). Conclusion: We found no evidence for these single foods to be protective against cognitive decline, with the exception of red wine, which reduced the risk for AD only in men. Women could be more susceptible to detrimental effects of alcohol.

KEYWORDS:

Alzheimer´s dementia; apolipoprotein E ε4; cognitive decline; dementia; food intake; gender; memory decline

 

The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial.

Lee CJ, Kim JY, Shim E, Hong SH, Lee M, Jeon JY, Park S.

Korean Circ J. 2018 Jul;48(7):637-651. doi: 10.4070/kcj.2017.0349.

PMID: 29968437

Abstract

BACKGROUND AND OBJECTIVES:

Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management.

METHODS:

Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period,

RESULTS:

Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (-5.2 mmHg; 95% CI, -8.3 to -2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, -2.5 to 3.3).

CONCLUSIONS:

In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.

KEYWORDS:

Diet; Exercise; Hypertension; Lifestyle; Prehypertension

 

Effect of Vitamin K Supplementation on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis.

Verma H, Garg R.

Endocr Metab Immune Disord Drug Targets. 2018 Jul 3. doi: 10.2174/1871530318666180703125007. [Epub ahead of print]

PMID: 29968548

Abstract

BACKGROUND:

Multiple cross sectional and longitudinal studies reported the benefits of vitamin K intake for management of cardiometabolic risk factors so as to minimize the risk of cardiovascular diseases.

OBJECTIVE:

In present systematic review and meta-analysis, we aimed to evaluate the effect of vitamin K supplementation on cardiometabolic risk factors.

METHODOLOGY:

A systematic literature search of PubMed, Cochrane central, Clinicaltrials.gov, Google Scholar, Web of Science, EBSCO and Scopus databases was done from inception to November, 2017. A total of 13 trials were selected for inclusion into the present systematic review to evaluate the effect of vitamin K supplementation on cardiometabolic risk factors in healthy or in population at high risk of cardiovascular diseases.

RESULTS:

Significant beneficial effects of vitamin K supplementation were found only in case of C-reactive protein ( p = 0.01) and insulin sensitivity index ( p <0.001), while no significant effects of vitamin K supplementation were found in case of total cholesterol (p=0.857), low density lipoprotein - cholesterol (p=0.964), high density lipoprotein - cholesterol (p=0.998), interleukin - 6 (p=0.766), systolic blood pressure (p=0.660), diastolic blood pressure (p=0.818), fasting plasma glucose (p=0.362), fasting plasma insulin (p=0.928) and homeostasis model assessment for insulin resistance (p=0.672).

CONCLUSION:

Presently available evidence are insufficient to ascertain the beneficial effects of vitamin K supplementation for the management of cardiometabolic risk factors. In order to explore the true potential of vitamin K supplementation for management of cardiometabolic diseases, large randomized placebo controlled trials are required in population with disturbed cardiometabolic profile.

KEYWORDS:

Vitamin K; cardiometabolic risk factors; menaquinones; phylloquinone; supplementation

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Prenatal Exposure to Acetaminophen and Risk for Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorder: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Cohort Studies.

Masarwa R, Levine H, Gorelik E, Reif S, Perlman A, Matok I.

Am J Epidemiol. 2018 Apr 24. doi: 10.1093/aje/kwy086. [Epub ahead of print]

PMID: 29688261

Abstract

Acetaminophen is the most commonly used analgesic and antipyretic during pregnancy. Evidence of neuro-disruptive properties is accumulating. Therefore, we sought to evaluate the risk for attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) in the offspring of women exposed to acetaminophen during pregnancy. We searched MEDLINE, EMBASE, and Cochrane up to January 2017. Data were independently extracted and assessed by two researchers. Seven eligible retrospective cohorts included 132,738 mother and child pairs and with a follow-up period of 3-11 years. Pooled risk ratio (RR) for ADHD was (RR=1.32, 95% CI 1.18,1.45, I2=61%), for ASD (RR=1.23, 95% CI1.13,1.32, I2=17%), and for hyperactivity symptoms (RR=1.23, 95% CI 1.01,1.49, I2=94%). In meta-regression analysis, the association between exposure and ADHD increased with childs' age upon follow-up and with the mean duration of exposure (β=0.0354, 95% CI 0.001,0.07), (β=0.006, 95% CI 0.009,0.01). The available data is of observational nature only. Studies differed gravely in exposure and outcome assessment. Acetaminophen use during pregnancy is associated with an increased risk for ADHD, ASD and hyperactivity symptoms. These findings are concerning, however, results should be interpreted with caution as the available evidence consists of observational studies and susceptible to several potential sources of bias.

 

Diabetes, plasma glucose and incidence of colorectal 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, Shen L, Zhou S, Liu J, Chen J, Li L, Holmes MV, Chen Z.

J Epidemiol Community Health. 2018 Jul 3. pii: jech-2018-210651. doi: 10.1136/jech-2018-210651. [Epub ahead of print]

PMID: 29970599

Abstract

BACKGROUND:

Diabetes is associated with higher risk of colorectal cancer (CRC). Uncertainty remains about the relevance of duration of diabetes and about the association of blood glucose with CRC risk among individuals without diabetes.

METHODS:

The prospective China Kadoorie Biobank recruited 512 713 participants in 2004-2008 from 10 diverse areas in China. After 10 years of follow-up, 3024 incident cases of CRC (1745 colon, 1716 rectal) were recorded among 510 136 participants without prior cancer at baseline. Cox regression was used to estimate adjusted HRs for CRC associated with diabetes (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG).

RESULTS:

Overall 5.8% of participants had diabetes at baseline. Individuals with diabetes had an adjusted HR of 1.18 (95% CI 1.04 to 1.33) for CRC, with similar risk for colon and rectal cancer (1.19 [1.01 to 1.39] vs 1.14 [0.96 to 1.35]). The HRs decreased with longer duration of diabetes (p for trend 0.03). Among those without previously diagnosed diabetes, RPG was positively associated with CRC, with adjusted HRs per 1 mmol/L higher baseline RPG of 1.04 (1.02 to 1.05) for CRC, again similar for colon and rectal cancer (1.03 [1.01to 1.05] and 1.04 [1.02 to 1.06], respectively). The associations of diabetes and RPG appeared stronger in men than in women, but the differences were non-significant (p for heterogeneity 0.3 and 0.2).

DISCUSSION:

Among Chinese adults, diabetes and higher blood glucose levels among those without known diabetes are associated with higher risk of CRC.

KEYWORDS:

Chinese; blood glucose; colorectal cancer; diabetes

 

Dietary manganese and type 2 diabetes mellitus: two prospective cohort studies in China.

Du S, Wu X, Han T, Duan W, Liu L, Qi J, Niu Y, Na L, Sun C.

Diabetologia. 2018 Jul 3. doi: 10.1007/s00125-018-4674-3. [Epub ahead of print]

PMID: 29971528

Abstract

AIMS/HYPOTHESIS:

The association between dietary Mn and type 2 diabetes is unclear. We aimed to elucidate whether dietary Mn is associated with type 2 diabetes, to investigate whether this association is independent of dietary total antioxidant capacity (TAC) and to explore the underlying mechanisms in their association.

METHODS:

Two prospective cohorts of 3350 and 7133 Chinese adults (20-74 years old) were enrolled including, respectively, 244 and 578 individuals newly diagnosed with type 2 diabetes, with mean values of 4.2 and 5.3 years of follow-up. Cox's proportional-hazards regression and linear regression were performed to investigate the association between dietary Mn and type 2 diabetes (diagnosed by OGTT) or HbAlc and to analyse the joint association between dietary Mn and TAC. Restricted cubic spline (RCS) regression was applied to the non-linear association between dietary Mn and incidence of type 2 diabetes. Mediation analysis was applied to explore potential mediators in their association in a subgroup of 500 participants.

RESULTS:

Dietary Mn intakes were 4.58 ± 1.04 and 4.61 ± 1.08 (mean ± SD) mg/day in the two cohorts. Dietary Mn was inversely associated with type 2 diabetes incidence and HbAlc concentration in both cohorts (ptrend < 0.01 and <0.01 for type 2 diabetes, and ptrend < 0.01 and =0.02 for HbAlc, respectively, in each cohort) independent of TAC, adjusted for age, sex, BMI, tobacco use, alcohol consumption, physical activity, diabetes inheritance, total energy, carbohydrate, total fatty acids, fibre, calcium, Mg, hypertension, hyperlipidaemia, and impaired glucose tolerance or FBG (all at baseline). Their inverse association was stronger in the presence of diets with high, compared with low, TAC. In RCS, intakes of >6.01 and 6.10-6.97 mg/day were associated with a significantly lower type 2 diabetes incidence in the two respective cohorts. Mediation analysis showed that high plasma Mn and low oxidative stress (increased Mn superoxide dismutase and decreased 8-hydroxydeoxyguanosine) contributed to the association between dietary Mn and both type 2 diabetes and HbAlc.

CONCLUSIONS/INTERPRETATION:

Dietary Mn was inversely associated with type 2 diabetes independently of TAC. In addition, this association was stronger in a high- rather than low-TAC diet. Plasma Mn and oxidative stress were mediators in the association between dietary Mn and type 2 diabetes. Future studies on absolute Mn intake should be conducted to study the potential non-linearity and optimal levels of dietary Mn and type 2 diabetes.

KEYWORDS:

Antioxidant capacity; Diet; Manganese; Type 2 diabetes

 

The Carbohydrate-Insulin Model of Obesity: Beyond "Calories In, Calories Out".

Ludwig DS, Ebbeling CB.

JAMA Intern Med. 2018 Jul 2. doi: 10.1001/jamainternmed.2018.2933. [Epub ahead of print]

PMID: 29971406

Abstract

Despite intensive research, the causes of the obesity epidemic remain incompletely understood and conventional calorie-restricted diets continue to lack long-term efficacy. According to the carbohydrate-insulin model (CIM) of obesity, recent increases in the consumption of processed, high-glycemic-load carbohydrates produce hormonal changes that promote calorie deposition in adipose tissue, exacerbate hunger, and lower energy expenditure. Basic and genetic research provides mechanistic evidence in support of the CIM. In animals, dietary composition has been clearly demonstrated to affect metabolism and body composition, independently of calorie intake, consistent with CIM predictions. Meta-analyses of behavioral trials report greater weight loss with reduced-glycemic load vs low-fat diets, though these studies characteristically suffer from poor long-term compliance. Feeding studies have lacked the rigor and duration to test the CIM, but the longest such studies tend to show metabolic advantages for low-glycemic load vs low-fat diets. Beyond the type and amount of carbohydrate consumed, the CIM provides a conceptual framework for understanding how many dietary and nondietary exposures might alter hormones, metabolism, and adipocyte biology in ways that could predispose to obesity. Pending definitive studies, the principles of a low-glycemic load diet offer a practical alternative to the conventional focus on dietary fat and calorie restriction.

 

Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study.

Lee DH, Keum N, Hu FB, Orav EJ, Rimm EB, Willett WC, Giovannucci EL.

BMJ. 2018 Jul 3;362:k2575. doi: 10.1136/bmj.k2575.

PMID: 29970408

https://www.bmj.com/content/362/bmj.k2575

Abstract

OBJECTIVE:

To investigate the association of predicted lean body mass, fat mass, and body mass index (BMI) with all cause and cause specific mortality in men.

DESIGN:

Prospective cohort study.

SETTING:

Health professionals in the United States PARTICIPANTS: 38 006 men (aged 40-75 years) from the Health Professionals Follow-up Study, followed up for death (1987-2012).

MAIN OUTCOME MEASURES:

All cause and cause specific mortality.

RESULTS:

Using validated anthropometric prediction equations previously developed from the National Health and Nutrition Examination Survey, lean body mass and fat mass were estimated for all participants. During a mean of 21.4 years of follow-up, 12 356 deaths were identified. A J shaped association was consistently observed between BMI and all cause mortality. Multivariable adjusted Cox models including predicted fat mass and lean body mass showed a strong positive monotonic association between predicted fat mass and all cause mortality. Compared with those in the lowest fifth of predicted fat mass, men in the highest fifth had a hazard ratio of 1.35 (95% confidence interval 1.26 to 1.46) for mortality from all causes. In contrast, a U shaped association was found between predicted lean body mass and all cause mortality. Compared with those in the lowest fifth of predicted lean body mass, men in the second to fourth fifths had 8-10% lower risk of mortality from all causes. In the restricted cubic spline models, the risk of all cause mortality was relatively flat until 21 kg of predicted fat mass and increased rapidly afterwards, with a hazard ratio of 1.22 (1.18 to 1.26) per standard deviation. For predicted lean body mass, a large reduction of the risk was seen within the lower range until 56 kg, with a hazard ratio of 0.87 (0.82 to 0.92) per standard deviation, which increased thereafter (P for non-linearity <0.001). For cause specific mortality, men in the highest fifth of predicted fat mass had hazard ratios of 1.67 (1.47 to 1.89) for cardiovascular disease, 1.24 (1.09 to 1.43) for cancer, and 1.26 (0.97 to 1.64) for respiratory disease. On the other hand, a U shaped association was found between predicted lean body mass and mortality from cardiovascular disease and cancer. However, a strong inverse association existed between predicted lean body mass and mortality from respiratory disease (P for trend <0.001).

CONCLUSIONS:

The shape of the association between BMI and mortality was determined by the relation between two body components (lean body mass and fat mass) and mortality. This finding suggests that the "obesity paradox" controversy may be largely explained by low lean body mass, rather than low fat mass, in the lower range of BMI.

 

Alcohol Consumption, Hypertension, and Cardiovascular Health Across the Life Course: There Is No Such Thing as a One-Size-Fits-All Approach.

Bell S.

J Am Heart Assoc. 2018 Jun 27;7(13). pii: e009698. doi: 10.1161/JAHA.118.009698. No abstract available.

PMID: 29950487 Free Article

http://jaha.ahajournals.org/content/7/13/e009698.long

KEYWORDS:

Editorials; alcohol; high blood pressure; hypertension; lifetime risk; longitudinal cohort study; risk

 

Tea Consumption and Longitudinal Change in High-Density Lipoprotein Cholesterol Concentration in Chinese Adults.

Huang S, Li J, Wu Y, Ranjbar S, Xing A, Zhao H, Wang Y, Shearer GC, Bao L, Lichtenstein AH, Wu S, Gao X.

J Am Heart Assoc. 2018 Jun 25;7(13). pii: e008814. doi: 10.1161/JAHA.118.008814.

PMID: 29941658 Free Article

http://jaha.ahajournals.org/content/7/13/e008814.long

Abstract

BACKGROUND:

The relation between tea consumption and age-related changes in high-density lipoprotein cholesterol (HDL-C) concentrations remains unclear, and longitudinal human data are limited. The aim of current study was to examine the relation between tea intake and longitudinal change in HDL-C concentrations.

METHODS AND RESULTS:

Baseline (2006) tea consumption was assessed via a questionnaire, and plasma HDL-C concentrations were measured in 2006, 2008, 2010, and 2012 among 80 182 individuals (49±12 years of age) who did not have cardiovascular diseases or cancer, or did not use cholesterol-lowering agents both at baseline (2006) and during the follow-up period (2006-2012). The associations between baseline tea consumption and rate of change in HDL-C concentrations were examined using generalized estimating equation models. Tea consumption was inversely associated with a decreased rate of HDL-C concentrations (P-trend <0.0001) in the fully adjusted model. The adjusted mean difference in the HDL-C decreased rate was 0.010 (95% confidence interval, 0.008, 0.012) mmol/L per year for tea consumers versus nonconsumers (never or less than once/month group). Interactions between tea consumption and age, sex, lifestyle scores, and metabolic syndrome (all P-interaction <0.0001) were identified. The associations between greater tea consumption and slower decrease in HDL-C concentrations were more pronounced in men, individuals aged 60 or older, individuals with a lower lifestyle score, and individuals with metabolic syndrome (all P-trend <0.0001).

CONCLUSIONS:

Tea consumption was associated with slower age-related decreases in HDL-C concentrations during 6 years of follow-up.

KEYWORDS:

cardiovascular disease risk factors; catechins; high‐density lipoprotein cholesterol; lipids and lipoproteins; longitudinal cohort study; nutrition; polyphenols

 

Dietary Docosahexaenoic Acid Reduces Oscillatory Wall Shear Stress, Atherosclerosis, and Hypertension, Most Likely Mediated via an IL-1-Mediated Mechanism.

Alfaidi MA, Chamberlain J, Rothman A, Crossman D, Villa-Uriol MC, Hadoke P, Wu J, Schenkel T, Evans PC, Francis SE.

J Am Heart Assoc. 2018 Jun 30;7(13). pii: e008757. doi: 10.1161/JAHA.118.008757.

PMID: 29960988 Free Article

http://jaha.ahajournals.org/content/7/13/e008757.long

Abstract

BACKGROUND:

Hypertension is a complex condition and a common cardiovascular risk factor. Dietary docosahexaenoic acid (DHA) modulates atherosclerosis and hypertension, possibly via an inflammatory mechanism. IL-1 (interleukin 1) has an established role in atherosclerosis and inflammation, although whether IL-1 inhibition modulates blood pressure is unclear.

METHODS AND RESULTS:

Male apoE-/- (apolipoprotein E-null) mice were fed either a high fat diet or a high fat diet plus DHA (300 mg/kg per day) for 12 weeks. Blood pressure and cardiac function were assessed, and effects of DHA on wall shear stress and atherosclerosis were determined. DHA supplementation improved left ventricular function, reduced wall shear stress and oscillatory shear at ostia in the descending aorta, and significantly lowered blood pressure compared with controls (119.5±7 versus 159.7±3 mm Hg, P<0.001, n=4 per group). Analysis of atheroma following DHA feeding in mice demonstrated a 4-fold reduction in lesion burden in distal aortas and in brachiocephalic arteries (P<0.001, n=12 per group). In addition, DHA treatment selectively decreased plaque endothelial IL-1β (P<0.01).

CONCLUSIONS:

Our findings revealed that raised blood pressure can be reduced by inhibiting IL-1 indirectly by administration of DHA in the diet through a mechanism that involves a reduction in wall shear stress and local expression of the proinflammatory cytokine IL-1β.

KEYWORDS:

docosahexaenoic acid; endothelium; hypertension; inflammation; interleukin 1; wall shear stress

 

Sex-Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies.

Roerecke M, Tobe SW, Kaczorowski J, Bacon SL, Vafaei A, Hasan OSM, Krishnan RJ, Raifu AO, Rehm J.

J Am Heart Assoc. 2018 Jun 27;7(13). pii: e008202. doi: 10.1161/JAHA.117.008202. Review.

PMID: 29950485 Free Article

http://jaha.ahajournals.org/content/7/13/e008202.long

Abstract

BACKGROUND:

Although it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear.

METHODS AND RESULTS:

We searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of hypertension in people without hypertension. Random-effects meta-analyses and metaregressions were conducted. Data from 20 articles with 361 254 participants (125 907 men and 235 347 women) and 90 160 incident cases of hypertension (32 426 men and 57 734 women) were included. In people drinking 1 to 2 drinks/day (12 g of pure ethanol per drink), incidence of hypertension differed between men and women (relative riskwomen vs men=0.79; 95% confidence interval, 0.67-0.93). In men, the risk for hypertension in comparison with abstainers was relative risk=1.19 (1.07-1.31; I2=59%), 1.51 (1.30-1.76), and 1.74 (1.35-2.24) for consumption of 1 to 2, 3 to 4, and 5 or more standard drinks per day, respectively. In women, there was no increased risk for 1 to 2 drinks/day (relative risk=0.94; 0.88-1.01; I2=73%), and an increased risk for consumption beyond this level (relative risk=1.42; 1.22-1.66).

CONCLUSIONS:

Any alcohol consumption was associated with an increase in the risk for hypertension in men. In women, there was no risk increase for consumption of 1 to 2 drinks/day and an increased risk for higher consumption levels. We did not find evidence for a protective effect of alcohol consumption in women, contrary to earlier meta-analyses.

KEYWORDS:

alcohol; cohort studies; hypertension; meta‐analysis; systematic review

 

Association of Coffee Drinking With Mortality by Genetic Variation in Caffeine Metabolism: Findings From the UK Biobank.

Loftfield E, Cornelis MC, Caporaso N, Yu K, Sinha R, Freedman N.

JAMA Intern Med. 2018 Jul 2. doi: 10.1001/jamainternmed.2018.2425. [Epub ahead of print]

PMID: 29971434

Abstract

IMPORTANCE:

Prospective cohorts in North America, Europe, and Asia show consistent inverse associations between coffee drinking and mortality, including deaths from cardiovascular disease and some cancers. However, concerns about coffee, particularly among people with common genetic polymorphisms affecting caffeine metabolism and among those drinking more than 5 cups per day, remain.

OBJECTIVE:

To evaluate associations of coffee drinking with mortality by genetic caffeine metabolism score.

DESIGN, SETTING, AND PARTICIPANTS:

The UK Biobank is a population-based study that invited approximately 9.2 million individuals from across the United Kingdom to participate. We used baseline demographic, lifestyle, and genetic data form the UK Biobank cohort, with follow-up beginning in 2006 and ending in 2016, to estimate hazard ratios (HRs) for coffee intake and mortality, using multivariable-adjusted Cox proportional hazards models. We investigated potential effect modification by caffeine metabolism, defined by a genetic score of previously identified polymorphisms in AHR, CYP1A2, CYP2A6, and POR that have an effect on caffeine metabolism. Of the 502 641 participants who consented with baseline data, we included those who were not pregnant and had complete data on coffee intake and smoking status (n = 498 134).

EXPOSURES:

Total, ground, instant, and decaffeinated coffee intake.

MAIN OUTCOMES AND MEASURES:

All-cause and cause-specific mortality.

RESULTS:

The mean age of the participants was 57 years (range, 38-73 years); 271 019 (54%) were female, and 387 494 (78%) were coffee drinkers. Over 10 years of follow-up, 14 225 deaths occurred. Coffee drinking was inversely associated with all-cause mortality. Using non-coffee drinkers as the reference group, HRs for drinking less than 1, 1, 2 to 3, 4 to 5, 6 to 7, and 8 or more cups per day were 0.94 (95% CI, 0.88-1.01), 0.92 (95% CI, 0.87-0.97), 0.88 (95% CI, 0.84-0.93), 0.88 (95% CI, 0.83-0.93), 0.84 (95% CI, 0.77-0.92), and 0.86 (95% CI, 0.77-0.95), respectively. Similar associations were observed for instant, ground, and decaffeinated coffee, across common causes of death, and regardless of genetic caffeine metabolism score. For example, the HRs for 6 or more cups per day ranged from 0.70 (95% CI, 0.53-0.94) to 0.92 (95% CI, 0.78-1.10), with no evidence of effect modification across strata of caffeine metabolism score (P = .17 for heterogeneity).

CONCLUSIONS AND RELEVANCE:

Coffee drinking was inversely associated with mortality, including among those drinking 8 or more cups per day and those with genetic polymorphisms indicating slower or faster caffeine metabolism. These findings suggest the importance of noncaffeine constituents in the coffee-mortality association and provide further reassurance that coffee drinking can be a part of a healthy diet.

 

Circulating isoflavone and lignan concentrations and prostate cancer risk: A meta-analysis of individual participant data from seven prospective studies including 2828 cases and 5593 controls.

Perez-Cornago A, Appleby PN, Boeing H, Gil L, Kyrø C, Ricceri F, Murphy N, Trichopoulou A, Tsilidis KK, Khaw KT, Luben RN, Gislefoss RE, Langseth H, Drake I, Sonestedt E, Wallström P, Stattin P, Johansson A, Landberg R, Nilsson LM, Ozasa K, Tamakoshi A, Mikami K, Kubo T, Sawada N, Tsugane S, Key TJ, Allen NE, Travis RC.

Int J Cancer. 2018 Jul 4. doi: 10.1002/ijc.31640. [Epub ahead of print]

PMID: 29971774

Abstract

Phytoestrogens may influence prostate cancer development. This study aimed to examine the association between pre-diagnostic circulating concentrations of isoflavones (genistein, daidzein, equol) and lignans (enterolactone and enterodiol) and the risk of prostate cancer. Individual participant data were available from seven prospective studies (two studies from Japan with 241 cases and 503 controls and five studies from Europe with 2,828 cases and 5,593 controls). Because of the large difference in circulating isoflavone concentrations between Japan and Europe, analyses of the associations of isoflavone concentrations and prostate cancer risk were evaluated separately. Prostate cancer risk by study-specific fourths of circulating concentrations of each phytoestrogen was estimated using multivariable-adjusted conditional logistic regression. In men from Japan, those with high compared to low circulating equol concentrations had a lower risk of prostate cancer (multivariable-adjusted OR for upper quartile [Q4] vs Q1=0.61, 95% confidence interval [CI]=0.39-0.97), although there was no significant trend (OR per 75 percentile increase=0.69, 95 CI=0.46-1.05, Ptrend =0.085); Genistein and daidzein concentrations were not significantly associated with risk (ORs for Q4 vs Q1=0.70, 0.45-1.10, and 0.71, 0.45-1.12, respectively). In men from Europe, circulating concentrations of genistein, daidzein and equol were not associated with risk. Circulating lignan concentrations were not associated with the risk of prostate cancer, overall or by disease aggressiveness or time to diagnosis. There was no strong evidence that pre-diagnostic circulating concentrations of isoflavones or lignans are associated with prostate cancer risk, although further research is warranted in populations where isoflavone intakes are high.

KEYWORDS:

isoflavones; lignans; phytoestrogens; pooled analysis; prostate cancer risk

 

Alcohol consumption and risk of multiple myeloma in the NIH-AARP Diet and Health Study.

Santo L, Liao LM, Andreotti G, Purdue MP, Hofmann JN.

Int J Cancer. 2018 Jul 4. doi: 10.1002/ijc.31648. [Epub ahead of print]

PMID: 29971781

Abstract

The epidemiologic evidence regarding the relationship between alcohol consumption and multiple myeloma (MM) risk remains limited and inconsistent, although recent studies suggest a potential protective effect. We prospectively investigated the risk of MM in relation to alcohol consumption frequency among 499,292 participants enrolled in the National Institutes of Health (NIH)-AARP Diet and Health Study in 1995-1996. A total of 1,312 MM cases were identified during follow-up through December 2011. Hazard ratios (HR) and 95% confidence intervals (CI) for categories of alcohol consumption relative to those defined as light drinkers (<1 drink/week) were estimated using multivariate Cox proportional hazard models. Overall, increasing frequency of alcohol consumption was inversely associated with MM (P-trend=0.01), with a statistically significant association among those who consumed 2 drinks per day (HR=0.70, 95% CI: 0.50, 0.98); similar but not statistically signifant associations were observed for greater frequency of alcohol consumption. Among women, risk of MM was reduced among those who consumed less that one drink per day (HR=0.73, 95% CI: 0.56, 0.97) and associations with greater frequency of alcohol consumption were inverse although not statistically significant. The findings of this large prospective investigation suggest that moderate alcohol consumption may be associated with reduced future risk of MM.

KEYWORDS:

alcohol; cohort study; multiple myeloma

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Omega-3 Fatty Acid Supplementation and Cardiovascular Disease Risk: Glass Half Full or Time to Nail the Coffin Shut?

Maki KC, Dicklin MR.

Nutrients. 2018 Jul 4;10(7). pii: E864. doi: 10.3390/nu10070864. Review.

PMID: 29973554

Abstract

There has been a great deal of controversy in recent years about the potential role of dietary supplementation with long-chain omega-3 polyunsaturated fatty acids (n-3 PUFA) in the prevention of cardiovascular disease (CVD). Four recent meta-analyses have been published that evaluated randomized, controlled trial (RCT) data from studies that assessed the effects of supplemental n-3 PUFA intake on CVD endpoints. The authors of those reports reached disparate conclusions. This review explores the reasons informed experts have drawn different conclusions from the evidence, and addresses implications for future investigation. Although RCT data accumulated to date have failed to provide unequivocal evidence of CVD risk reduction with n-3 PUFA supplementation, many studies were limited by design issues, including low dosage, no assessment of n-3 status, and absence of a clear biological target or pathophysiologic hypothesis for the intervention. The most promising evidence supports n-3 PUFA supplementation for prevention of cardiac death. Two ongoing trials have enrolled high cardiovascular risk subjects with hypertriglyceridemia and are administering larger dosages of n-3 PUFA than employed in previous RCTs. These are expected to clarify the potential role of long-chain n-3 PUFA supplementation in CVD risk management.

KEYWORDS:

cardiac death; cardiovascular disease; coronary heart disease; diet recommendations; long-chain polyunsaturated fatty acids; meta-analyses; omega-3 fatty acids; randomized controlled trials; triglycerides

 

Selenium exposure and the risk of type 2 diabetes: a systematic review and meta-analysis.

Vinceti M, Filippini T, Rothman KJ.

Eur J Epidemiol. 2018 Jul 5. doi: 10.1007/s10654-018-0422-8. [Epub ahead of print] Review.

PMID: 29974401

Abstract

In 2007, supplementation with the trace element selenium in a trial was unexpectedly found to be associated with an excess risk of type 2 diabetes. Given the concerns raised by these findings and the large number of recent studies on this topic, we reviewed the available literature with respect to this possible association. In this paper, we assessed the results of both experimental and nonexperimental epidemiologic studies linking selenium with type 2 diabetes incidence. Through a systematic literature search, we retrieved 50 potentially eligible nonexperimental studies and 5 randomized controlled trials published through June 11, 2018. To elucidate the possible dose-response relation, we selected for further analysis those studies that included multiple exposure levels and serum or plasma levels. We computed a pooled summary risk ratio (RR) of diabetes according to selenium exposure in these studies. We also computed a RR for diabetes incidence following supplementation with 200 µg/day of selenium compared with placebo in trials. In the nonexperimental studies, we found a direct relation between selenium exposure and risk of diabetes, with a clear and roughly linear trend in subjects with higher plasma or serum selenium levels, with RR at 140 µg/L of selenium exposure compared with a referent category of < 45 µg/L equal to 3.6 [95% confidence interval (CI) 1.4-9.4]. A dose-response meta-analysis focusing on studies with direct assessment of dietary selenium intake showed a similar trend. In experimental studies, selenium supplementation increased the risk of diabetes by 11% (RR 1.11, 95% CI 1.01-1.22) compared with the placebo-allocated participants, with a higher RR in women than in men. Overall, results from both nonexperimental and experimental studies indicate that selenium may increase the risk of type 2 diabetes across a wide range of exposure levels. The relative increase in risk is small but of possible public health importance because of the high incidence of diabetes and the ubiquity of selenium exposure.

KEYWORDS:

Epidemiology; Meta-analysis; Selenium; Systematic review; Type 2 diabetes

 

Body fat percentage, waist circumference and obesity as risk factors for rheumatoid arthritis - A Danish cohort study.

Linauskas A, Overvad K, Symmons D, Johansen MB, Stengaard-Pedersen K, de Thurah A.

Arthritis Care Res (Hoboken). 2018 Jul 5. doi: 10.1002/acr.23694. [Epub ahead of print]

PMID: 29975015

Abstract

OBJECTIVES:

To investigate the relationship between bioimpedance-derived total body fat percentage, waist circumference (WC) and Body Mass Index (BMI) and the subsequent development of rheumatoid arthritis (RA).

METHODS:

A population-based prospective cohort study among 55,037 persons enrolled into the Danish Diet, Cancer and Health cohort. Baseline data included anthropometric measures and lifestyle factors. Persons who developed RA were identified through linkage with the Danish National Patient Registry. The relationships between bioimpedance-derived body fat percentage, WC, BMI and incident RA were assessed using Cox proportional hazards regression models, stratifying by gender. All analyses were performed for overall RA and the serological subtypes: 'seropositive RA' and 'other RA'.

RESULTS:

A total of 210 men (37.6% seropositive RA) and 456 women (41.0% seropositive RA) developed RA during a median follow-up of 20.1 years. In women, overall RA risk was 10% higher for each 5% increment of total body fat (Hazard Ratio (HR) 1.10; 95% CI 1.02-1.18), 5% higher for each 5cm increment of WC (HR 1.05; 95% CI 1.01-1.10) and nearly 50% higher in those with an obese compared to normal BMI (HR 1.46; 95% CI 1.12-1.90). These positive associations were also found for 'other RA'. In men, there were no clear associations between body fat percentage, WC, or BMI and RA. No significant associations were found for 'seropositive RA' in women or men, possibly related to low sample size.

CONCLUSIONS:

In women, higher body fat percentage, higher waist circumference and obesity were associated with higher risk of RA.

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Fruit and vegetable consumption and breast cancer incidence: Repeated measures over 30 years of follow-up.

Farvid MS, Chen WY, Rosner BA, Tamimi RM, Willett WC, Eliassen AH.

Int J Cancer. 2018 Jul 6. doi: 10.1002/ijc.31653. [Epub ahead of print]

PMID: 29978479

Abstract

We evaluated the relation of fruit and vegetable consumption, including specific fruits and vegetables, with incident breast cancer characterized by menopausal status, hormone receptor status, and molecular subtypes. Fruit and vegetable consumption, cumulatively averaged across repeated, validated questionnaires, was examined in relation to risk of invasive breast cancer among 182,145 women initially aged 27-59y in the Nurses' Health Study (NHS, 1980-2012) and NHSII (1991-2013). Cox proportional hazards regression, adjusted for known risk factors, was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and assessed tumors by hormone receptor status and molecular subtypes. We prospectively documented 10,911 invasive breast cancer cases. Greater intake of total fruits and vegetables, especially cruciferous and yellow/orange vegetables, was associated with significantly lower breast cancer risk (>5.5 versus ≤2.5 servings/day HR=0.89, 95%CI=0.83-0.96; Ptrend =0.005). Intake of total vegetables was especially associated with lower risk of estrogen receptor negative tumors (HR per 2 additional servings/day as a continuous variable=0.85, 95%CI=0.77-0.93; Pheterogeneity =0.02). Among molecular subtypes, higher intake of total fruits and vegetables (HR per 2 additional servings/day as a continuous variable) was most strongly associated with lower risk of human epidermal growth factor receptor 2 (HER2)-enriched (HR=0.78, 95%CI=0.66-0.92), basal-like (HR=0.85, 95%CI=0.73-0.99), and luminal A (HR=0.94, 95%CI=0.89-0.99), but not with luminal B tumors (Pheterogeneity =0.03). In conclusion, our findings support that higher intake of fruits and vegetables, and specifically cruciferous and yellow/orange vegetables, may reduce the risk of breast cancer, especially those that are more likely to be aggressive tumors.

 

Nut consumption and risk of metabolic syndrome and overweight/obesity: a meta-analysis of prospective cohort studies and randomized trials.

Li H, Li X, Yuan S, Jin Y, Lu J.

Nutr Metab (Lond). 2018 Jun 22;15:46. doi: 10.1186/s12986-018-0282-y. eCollection 2018.

PMID: 29977320

Abstract

BACKGROUND:

Nut consumption has been shown to reduce the risk of cardiovascular disease. However, its role in the prevention of metabolic disorders, such as metabolic syndrome (Mets) and overweight/obesity, remains controversial. We therefore conducted a meta-analysis to determine the association of nut consumption with Mets and overweight/obesity.

METHODS:

Eligible studies were identified by searching the PubMed and Embase databases and by reviewing the references of relevant literatures. We used random effect models to pool the studies-specific risk ratio (RR) and weighted mean difference (WMD).

RESULTS:

This meta-analysis included six prospective cohort studies with 420,890 subjects and 62 randomized feeding trials with 7184 participants. Among the cohort studies, the summary RR for every 1-serving/week increase in nut intake was 0.96 (95% confidence interval [CI]: 0.92 to 0.99; n = 3) for Mets, 0.97 (95% CI: 0.95 to 0.98; n = 2) for overweight/obesity, and 0.95 (95% CI: 0.89 to 1.02; n = 2) for obesity. Pooling of randomized trials indicated that nut consumption was related to a significant reduction in body weight (WMD: - 0.22 Kg, 95% CI: -0.40 to - 0.04), body mass index (WMD: - 0.16 Kg/m2, 95% CI: -0.31 to - 0.01), and waist circumference (WMD: - 0.51 cm, 95% CI: -0.95 to - 0.07). These findings remained stable in the sensitivity analysis, and no publication bias was detected.

CONCLUSION:

Nut consumption may be beneficial in the prevention of Mets and overweight/obesity. Additional prospective studies are needed to enhance these findings and to explore the metabolic benefits for specific subclasses of nut.

KEYWORDS:

Metabolic syndrome; Nutrition; Obesity; Overweight

 

Beet the Best? Dietary Inorganic Nitrate to Augment Exercise Training in Lower Extremity Peripheral Artery Disease with Intermittent Claudication.

Woessner MN, VanBruggen MD, Pieper CF, Sloane R, Kraus WE, Gow AJ, Allen JD.

Circ Res. 2018 Jul 5. pii: CIRCRESAHA.118.313131. doi: 10.1161/CIRCRESAHA.118.313131. [Epub ahead of print]

PMID: 29976553

https://sci-hub.tw/10.1161/CIRCRESAHA.118.313131

Abstract

Rationale: A primary goal of therapy for patients with peripheral arterial disease and intermittent claudication (PAD+IC) is increased ambulatory function. Supervised exercise rehabilitation was recently shown to confer superior walking benefits to pharmacological or surgical interventions. Increases in plasma inorganic nitrite, via oral nitrate, have been shown to increase exercise performance in both human and animal models, especially in hypoxic conditions. Objective: To determine whether a 36-session exercise rehabilitation program while consuming oral inorganic nitrate (4.2mmol concentrated beetroot juice- EX+BR) would produce superior benefits over exercise plus placebo (EX+PL) in pain free walking and markers of increased skeletal muscle perfusion in patients with PAD+IC. Methods and Results: This was a randomized, double-blind, per-protocol study design. Following the 12-week protocol claudication onset time (COT) on a maximal treadmill test increased by 59.2+57.3 sec for the EX+PL group (n=13), and by 180.3+46.6 sec for the EX+BR group (n=11) (p<0.05). This produced a between treatment medium to large standardized effect size (Cohen's d) of 0.62 (95%CI = -0.23 to +1.44). The data for six minute walk (6MW) distance showed a similar pattern with increases of 24.6+12.1 m and 53.3+19.6 m (p<0.05) in the EX+PL and EX+BR groups respectively. Measures of gastrocnemius perfusion including ABI, peak reactive hyperemic blood flow and tissue deoxygenation characteristics during exercise (assessed my near infra-red spectroscopy) all changed significantly for the EX+BR group with moderate to large effect sizes over EX+PL changes. Conclusions: While it is premature to speculate on overall clinical utility of a nitrate based therapy for PAD, this early pilot study evidence is encouraging. Specifically, our data suggests that increasing plasma nitrite prior to exercise may allow PAD subjects to train with less pain, at higher workloads for longer durations at each training session thereby maximizing the beneficial peripheral vascular and skeletal muscle adaptations.Clinical Trial Registration: (NCT01684930, NCT01785524).

KEYWORDS:

exercise; intermittent claudication; nitrate; nitric oxide; nitrite; peripheral artery disease; vasculature

 

Subclinical Hypothyroidism and the Risk of Cardiovascular Disease and All-Cause Mortality: a Meta-Analysis of Prospective Cohort Studies.

Moon S, Kim MJ, Yu JM, Yoo HJ, Park YJ.

Thyroid. 2018 Jul 6. doi: 10.1089/thy.2017.0414. [Epub ahead of print]

PMID: 29978767

https://sci-hub.tw/10.1089/thy.2017.0414

Abstract

Objectives To determine the impact of subclinical hypothyroidism (SCH) on the risk of cardiovascular disease (CVD) and all-cause mortality, we performed a comprehensive meta-analysis, according to the age or coexisting CVD risk status of the participants. Methods Studies regarding the association of SCH with all-cause mortality from PubMed and Embase databases were included. We calculated the pooled relative risk (RR) of CVD and all-cause mortality using the Mantel-Haenszel method. We conducted a subgroup analysis of participants with high CVD risk, including history of coronary, cerebral, or peripheral artery disease; dilated cardiomyopathy; heart failure; atrial fibrillation; venous thromboembolism; diabetes mellitus; or chronic kidney disease. Results In total, 35 eligible articles incorporating 555,530 participants were included. SCH was modestly associated with CVD and all-cause mortality (RR for CVD, 1.33; 95% confidence interval [CI], 1.14-1.54; RR for all-cause mortality, 1.20; 95% CI, 1.07-1.34). However, the association was not observed in participants aged ≥65 years. Subgroup analysis showed that participants with SCH and high CVD risk showed a significantly higher risk of all-cause mortality (RR for CVD, 2.20; 95% CI, 1.28-3.77; RR for all-cause mortality, 1.66; 95% CI, 1.41-1.94), whereas those with SCH and low CVD risk did not. Additional subgroup analysis of six studies with a mean participant age of ≥65 years and high CVD risk showed a significant high risk of all-cause mortality in the SCH group (RR, 1.41; 95% CI, 1.08-1.85; I2 = 0%). Conclusions SCH is associated with an increased CVD risk and all-cause mortality, particularly in participants with high CVD risk.

 

Obesity—kills 1 in 14 people currently—do you really care?

Seamas C Donnelly

QJM: An International Journal of Medicine, Volume 111, Issue 7, 1 July 2018, Pages 435, https://doi.org/10.1093/qjmed/hcy134

Published: 03 July 2018

Obesity and its complications currently kills more people than road traffic accidents, terrorist attacks and Alzheimer’s disease combined. In England, the numbers of overweight/obese adults increased from 36 to 62% between 1980 and 2013. So that death rate will exponentially climb. Do we really care?

We really should. It is therefore appropriate that we publish a seminal review on the complications of obesity by Dr Kinlen and colleagues. This expanding list now includes enhanced risk for cancer, fractures, hypertension, diabetes, heart disease, stroke, dementia, asthma and obstructive sleep apnoea. In the context of cancer, it has been estimated that obesity accounts for up to 30%...

 

Complications of obesity.

Kinlen D, Cody D, O'Shea D.

QJM. 2017 Jul 24. doi: 10.1093/qjmed/hcx152. [Epub ahead of print]

PMID: 29025162

https://academic.oup.com/qjmed/article/111/7/437/4016386

Abstract

Global obesity rates have increased exponentially in recent decades. People are becoming obese younger, morbid obesity is increasing and the full health implications are only beginning to be seen. This article discusses the latest epidemiological data on obesity in adults and children, and systemically reviews the complications associated with the condition.

 

Fish consumption and risk of stroke, coronary heart disease, and cardiovascular mortality in a Dutch population with low fish intake.

Hengeveld LM, Praagman J, Beulens JWJ, Brouwer IA, van der Schouw YT, Sluijs I.

Eur J Clin Nutr. 2018 May 22. doi: 10.1038/s41430-018-0190-2. [Epub ahead of print]

PMID: 29795239

Abstract

BACKGROUND/OBJECTIVES:

Fish consumption of at least 1 portion/week is related to lower cardiovascular disease (CVD) risk. It is uncertain whether a less frequent intake is also beneficial and whether the type of fish matters. We investigated associations of very low intakes of total, fatty, and lean fish, compared with no fish intake, with 18-year incidences of stroke, coronary heart disease (CHD), and CVD mortality.

METHODS:

Data were used from 34,033 participants, aged 20-70 years, of the EPIC-Netherlands cohort. Baseline (1993-1997) fish consumption was estimated using a food frequency questionnaire. We compared any fish consumption, <1 portion/week (<100 g) and ≥1 portion/week to non-fish consumption.

RESULTS:

During 18 follow-up years, 753 stroke events, 2134 CHD events, and 540 CVD deaths occurred. Among the fish consumers (~92%) median intakes of total, lean, and fatty fish were 57.9, 32.9, and 10.7 g/week, respectively. Any fish consumption compared with non-consumption was not associated with incidences of stroke, CHD, MI, and CVD mortality. Furthermore, consumption of <1 portion/week of total, fatty, or lean fish was not associated with any CVD outcome, as compared with non-consumption. Consumption of ≥1 portion/week of lean fish (HR: 0.70, 95% CI: 0.57-0.86) and of fatty fish (HR: 0.63, 95% CI: 0.39-1.02) were associated with lower incidence of ischaemic stroke.

CONCLUSIONS:

Baseline fish consumption of <1 portion/week, regardless of the type of fish, was unrelated to incidences of stroke, CHD, and CVD mortality in this Dutch cohort. Consumption of ≥1 portion/week of fatty or of lean fish reduced the incidence of ischaemic stroke.

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Effects of walnut consumption on blood lipids and other cardiovascular risk factors: an updated meta-analysis and systematic review of controlled trials.

Guasch-Ferré M, Li J, Hu FB, Salas-Salvadó J, Tobias DK.

Am J Clin Nutr. 2018 Jul 1;108(1):174-187. doi: 10.1093/ajcn/nqy091.

PMID: 29931130

Abstract

BACKGROUND:

Intervention studies suggest that incorporating walnuts into the diet may improve blood lipids without promoting weight gain.

OBJECTIVE:

We conducted a systematic review and meta-analysis of controlled trials evaluating the effects of walnut consumption on blood lipids and other cardiovascular risk factors.

DESIGN:

We conducted a comprehensive search of PubMed and EMBASE databases (from database inception to January 2018) of clinical trials comparing walnut-enriched diets with control diets. We performed random-effects meta-analyses comparing walnut-enriched and control diets for changes in pre-post intervention in blood lipids (mmol/L), apolipoproteins (mg/dL), body weight (kg), and blood pressure (mm Hg).

RESULTS:

Twenty-six clinical trials with a total of 1059 participants were included. The following weighted mean differences (WMDs) in reductions were obtained for walnut-enriched diets compared with control groups: -6.99 mg/dL (95% CI: -9.39, -4.58 mg/dL; P < 0.001) (3.25% greater reduction) for total blood cholesterol (TC) and -5.51 mg/dL (95% CI: -7.72, -3.29 mg/dL; P < 0.001) (3.73% greater reduction) for low-density lipoprotein (LDL) cholesterol. Triglyceride concentrations were also reduced in walnut-enriched diets compared with control [WMD = -4.69 (95% CI: -8.93, -0.45); P = 0.03; 5.52% greater reduction]. More pronounced reductions in blood lipids were observed when walnut interventions were compared with American and Western diets [WMD for TC = -12.30 (95% CI: -23.17, -1.43) and for LDL = -8.28 (95% CI: -13.04, -3.51); P < 0.001]. Apolipoprotein B (mg/dL) was also reduced significantly more on walnut-enriched diets compared with control groups [WMD = -3.74 (95% CI: -6.51, -0.97); P = 0.008] and a trend towards a reduction was observed for apolipoprotein A [WMD = -2.91 (95% CI: -5.98, 0.08); P = 0.057]. Walnut-enriched diets did not lead to significant differences in weight change (kg) compared with control diets [WMD = -0.12 (95% CI: -2.12, 1.88); P = 0.90], systolic blood pressure (mm Hg) [WMD = -0.72 (95% CI: -2.75, 1.30); P = 0.48], or diastolic blood pressure (mm Hg) [WMD = -0.10 (95% CI: -1.49, 1.30); P = 0.88].

CONCLUSIONS:

Incorporating walnuts into the diet improved blood lipid profile without adversely affecting body weight or blood pressure.

 

Plasma trimethylamine-N-oxide and related metabolites are associated with type 2 diabetes risk in the Prevención con Dieta Mediterránea (PREDIMED) trial.

Papandreou C, Bulló M, Zheng Y, Ruiz-Canela M, Yu E, Guasch-Ferré M, Toledo E, Clish C, Corella D, Estruch R, Ros E, Fitó M, Arós F, Fiol M, Lapetra J, Serra-Majem L, Gómez-Gracia E, Liang L, Fragkiadakis GA, Razquin C, Hu FB, Salas-Salvadó J.

Am J Clin Nutr. 2018 Jul 1;108(1):163-173. doi: 10.1093/ajcn/nqy058.

PMID: 29982310

Abstract

BACKGROUND:

The role of trimethylamine-N-oxide (TMAO) in type 2 diabetes (T2D) is currently partially understood and controversial.

OBJECTIVE:

The aim of this study was to investigate associations between TMAO and related metabolites with T2D risk in subjects at high risk of cardiovascular disease.

DESIGN:

This is a case-cohort design study within the Prevención con Dieta Mediterránea (PREDIMED) study, with 251 incident T2D cases and a random sample of 694 participants (641 noncases and 53 overlapping cases) without T2D at baseline (median follow-up: 3.8 y). We used liquid chromatography-tandem mass spectrometry to measure plasma TMAO, l-carnitine, betaine, lyso-phosphatidylcholine (LPC) and lyso-phosphatidylethanolamine (LPE) species, phosphocholine, α-glycerophosphocholine, and choline at baseline and after 1 y. We examined associations with the use of weighted Cox proportional hazard models, accounting for the weighted case-cohort design by the Barlow method.

RESULTS:

After adjustment for recognized T2D risk factors and multiple testing, individuals in the highest quartile of baseline TMAO and α-glycerophosphocholine had a lower risk of T2D [hr (95% CI): 0.52 (0.29, 0.89) and 0.46 (0.24, 0.89), respectively]. The HR (95% CI) comparing the extreme quartiles of betaine was 0.41 (0.23, 0.74). Similar trends were observed for C16:0 LPC, C18:1 LPC, C18:0 LPC, C20:4 LPC, C22:6 LPC, C18:1 LPC plasmalogen, and C16:0 LPE. After correcting for multiple comparisons, participants in the highest quartile of 1-y changes in oleic acid LPC plasmalogen concentrations had a lower T2D risk than the reference quartile.

CONCLUSION:

Whether the associations between plasma TMAO and certain metabolite concentrations with T2D risk reflect its pathophysiology or represent an epiphenomenon needs to be elucidated.

 

Fat label compared with fat content: gastrointestinal symptoms and brain activity in functional dyspepsia patients and healthy controls.

Lee IS, Kullmann S, Scheffler K, Preissl H, Enck P.

Am J Clin Nutr. 2018 Jul 1;108(1):127-135. doi: 10.1093/ajcn/nqy077.

PMID: 29924294

Abstract

BACKGROUND:

High-fat meals are associated with dyspeptic symptoms in functional dyspepsia (FD) patients. It is still unclear how fat is processed, or how FD symptoms and neuronal activities are modulated by psychological factors.

OBJECTIVE:

We investigated brain activity by functional magnetic resonance imaging (fMRI) after the ingestion of high- and low-fat foods with correct/incorrect fat information.

DESIGN:

We compared 12 FD patients and 14 healthy controls (HCs). We recorded resting-state fMRI on four different days before and after ingestion of four yogurts (200 mL, 10% or 0.1% fat, "low fat" or "high fat" label).

RESULTS:

FD patients showed more pronounced dyspeptic symptoms than did HCs, and symptoms were relieved less after consuming high fat-labeled yogurt than low fat-labeled yogurt, irrespective of the actual fat content. This is indicative of either a placebo effect of low-fat information or a nocebo effect of high-fat information on symptom expression. FD patients showed greater activity than did HCs in occipital areas before and after ingestion regardless of fat content and label, as well as greater activity in the middle frontal gyrus before ingestion. In addition, functional connectivity (FC) from the insula to the occipital cortex (I-O) increased after high fat ingestion and decreased after low fat ingestion in FD patients. FC from the insula to the precuneus (I-P) was higher in FD patients than in HCs after ingestion of low fat-labeled yogurt. In FD patients, I-O FC negatively correlated with nausea and I-P FC with FD symptom intensity, food craving, and depression.

CONCLUSIONS:

Our results endorse the importance of psychological perception of food on the incidence of dyspeptic symptoms and on the altered brain activities. These findings show the importance of cognitive components in perceptions of fat, food craving, depression, and brain functions in pathophysiologic mechanisms of FD.

 

Vegetarian diets and chronic kidney disease.

Chauveau P, Koppe L, Combe C, Lasseur C, Trolonge S, Aparicio M.

Nephrol Dial Transplant. 2018 Jul 5. doi: 10.1093/ndt/gfy164. [Epub ahead of print]

PMID: 29982610

Abstract

While dietary restriction of protein intake has long been proposed as a possible kidney-protective treatment, the effects of changes in the quality of ingested proteins on the prevalence and risk of progression of chronic kidney disease (CKD) have been scarcely studied; these two aspects are reviewed in the present article. The prevalence of hypertension, type 2 diabetes and metabolic syndrome, which are the main causes of CKD in Western countries, is lower in vegetarian populations. Moreover, there is a negative relationship between several components of plant-based diets and numerous factors related to CKD progression such as uraemic toxins, inflammation, oxidative stress, metabolic acidosis, phosphate load and insulin resistance. In fact, results from different studies seem to confirm a kidney-protective effect of plant-based diets in the primary prevention of CKD and the secondary prevention of CKD progression. Various studies have determined the nutritional safety of plant-based diets in CKD patients, despite the combination of a more or less severe dietary protein restriction. As observed in the healthy population, this dietary pattern is associated with a reduced risk of all-cause mortality in CKD patients. We propose that plant-based diets should be included as part of the clinical recommendations for both the prevention and management of CKD.

 

Association between exposure to desalinated sea water and ischemic heart disease, diabetes mellitus and colorectal cancer; A population-based study in Israel.

Shlezinger M, Amitai Y, Akriv A, Gabay H, Shechter M, Leventer-Roberts M.

Environ Res. 2018 Jul 3;166:620-627. doi: 10.1016/j.envres.2018.06.053. [Epub ahead of print]

PMID: 29982150

Abstract

BACKGROUND:

Drinking water (DW) is an important dietary source of magnesium. Recently, Israel has increased its use of desalinated seawater (DSW) as DW country-wide. Its negligible magnesium content, however, raises concern that consumption of DSW may be associated with hypomagnesemia and increase the risk of ischemic heart disease (IHD), diabetes mellitus (DM), and colorectal cancer (CRC).

OBJECTIVES:

We tested whether there was a change in incidence of negative health outcomes (IHD, DM, and CRC) following the introduction of DSW supply in a population-based ecologic study in Israel.

METHODS:

A historical prospective analysis was applied to members aged 25-76 during 2004-2013 of Clalit Health Services (Clalit), the largest healthcare provider in Israel, using its electronic medical record database. Multivariable analyses were adjusted for age, sex, socioeconomic status, smoking status, and body mass index.

RESULTS:

An increased odds ratio was found for IHD (0.96, 95% CI 0.93-0.99 at baseline and 1.06, 95% CI 1.02-1.11 at the end of the follow-up period), but no time trend was observed.

CONCLUSIONS:

We found that the risk for IHD increased during the study period. The risks for DM and CRC were unchanged. Long term studies are needed for assessing the risk for CRC due to the long latency. The higher risk for IHD has practical public health implications and raise the need to add magnesium to DSW.

KEYWORDS:

Colorectal cancer; Desalinated sea water; Diabetes mellitus; Drinking water; Ischemic heart disease; Magnesium

 

Effect of Dietary Carbohydrate Type on Serum Cardiometabolic Risk Indicators and Adipose Tissue Inflammatory Markers.

Meng H, Matthan NR, Fried SK, Berciano S, Walker ME, Galluccio JM, Lichtenstein AH.

J Clin Endocrinol Metab. 2018 Jun 21. doi: 10.1210/jc.2018-00667. [Epub ahead of print]

PMID: 29982704

Abstract

CONTEXT AND OBJECTIVE:

Direct comparisons among types of dietary carbohydrate on cardiometabolic risk indicators are limited. This study was designed to compare an isocaloric exchange of simple-, refined- and unrefined-carbohydrate on serum cardiometabolic risk indicators, adipose tissue inflammatory markers, and peripheral blood mononuclear cells (PBMC) fractional cholesterol efflux.

DESIGN, PARTICIPANTS AND MEASURES:

Participants (postmenopausal women and men [N=11], 65 ± 8 y, BMI 29.8 ± 3.2 kg/m2, LDL-cholesterol ≥ 2.6 mmol/L) were provided with diets (60%E total carbohydrate, 15%E protein, 25%E fat) for 4.5 weeks each using a randomized cross-over design, with 2-week washout periods. The variable component was an isocaloric exchange of simple-, refined- or unrefined-carbohydrate containing foods. Serum was used to determine lipoprotein, glucose, insulin and inflammatory marker concentrations. Abdominal subcutaneous adipose tissue was aspirated to assess macrophage and inflammatory marker gene expression, and ex vivo cytokine secretion, and PBMCs were isolated to assess ex vivo fractional cholesterol efflux.

RESULTS:

Fasting serum LDL- and nonHDL-cholesterol concentrations were higher after the refined- compared to simple- or unrefined-carbohydrate enriched diets (P < 0.01). Other serum measures, ex vivo fractional cholesterol efflux and adipose tissue gene expression and ex vivo cytokine secretion were similar among diets.

CONCLUSIONS:

Diets enriched in refined- compared to simple- or unrefined-carbohydrate resulted in higher fasting serum LDL- and nonHDL-cholesterol concentrations, but had little effect on other cardiometabolic risk indicators. This small study raises the intriguing possibility that refined-carbohydrate may have unique adverse effects on cardiometabolic risk indicators distinct from simple- and unrefined-carbohydrate.

 

The Effect of Physical Activity and Cardiorespiratory Fitness on All-Cause Mortality in Hong Kong Chinese Older Adults.

Lu Z, Woo J, Kwok T.

J Gerontol A Biol Sci Med Sci. 2018 Jul 9;73(8):1132-1137. doi: 10.1093/gerona/glx180.

PMID: 29029009

https://sci-hub.tw/

Abstract

BACKGROUND:

It is unclear whether physical activity (PA) could predict all-cause mortality independently of cardiorespiratory fitness, and there are relatively few studies evaluating the combined effect of PA and cardiorespiratory fitness on mortality.

METHODS:

We invited 1,242 Chinese older adults aged 69-94 years from the MrOs and MsOs cohort (Hong Kong) study for a 7-year follow-up. PA was measured by the Physical Activity Scale of the Elderly (PASE). Cardiorespiratory fitness, expressed as maximal oxygen uptake (VO2max), was assessed by performing symptom-limited maximal exercise testing on an electrically braked bicycle ergometer and 6-m walk test. We aimed to examine the independent and combined effect of PA and VO2max with all-cause mortality by cox proportional hazards models.

RESULTS:

Ninety-nine deaths occurred over a mean follow-up of 5.3 ± 0.8 years. PA was inversely associated with all-cause mortality in unadjusted and fully-adjusted models, and the association was still significant after further adjusted for VO2max. In stratified analysis, PA was significantly related to all-cause mortality within both unfit and fit strata. As compared with those being active and fit, physically inactive and cardiorespiratory unfit individuals had the highest all-cause mortality risk. Physically active but unfit individuals and inactive but fit individuals had similar all-cause mortality risk.

CONCLUSIONS:

Among older adults, PA was an important predictor of all-cause mortality independently of VO2max. High cardiorespiratory fitness does not necessarily confer low mortality risk in physically inactive older adults.

 

Chocolate intake and heart disease and stroke in the Women's Health Initiative: a prospective analysis.

Greenberg JA, Manson JE, Neuhouser ML, Tinker L, Eaton C, Johnson KC, Shikany JM.

Am J Clin Nutr. 2018 Jul 1;108(1):41-48. doi: 10.1093/ajcn/nqy073.

PMID: 29931040

Abstract

BACKGROUND:

Three recent meta-analyses found significant prospective inverse associations between chocolate intake and cardiovascular disease risk. Evidence from these meta-analyses suggests that such inverse associations may only apply to elderly individuals or those with pre-existing major chronic disease.

OBJECTIVE:

We assessed the association between habitual chocolate intake and subsequent incident coronary heart disease (CHD) and stroke, and the potential effect of modification by age.

DESIGN:

We conducted multivariable Cox regression analyses using data from 83,310 postmenopausal women free of baseline pre-existing major chronic disease in the prospective Women's Health Initiative cohort. Chocolate intake was assessed using a food-frequency questionnaire. Physician-adjudicated events or deaths were ascertained up to 30 September 2013.

RESULTS:

After exclusions, there were 3246 CHD and 2624 stroke events or deaths, representing incidence rates of 3.9% and 3.2% during 1,098,091 and 1,101,022 person-years (13.4 y), respectively. We found no association between consumption of chocolate and risk of CHD (P for linear trend = 0.94) or stroke (P = 0.24). The results for CHD and stroke combined were similar (P = 0.30), but were significantly modified by age (P for interaction = 0.02). For women age <65 y at baseline, those who ate 1 oz (28.35 g) of chocolate <1/mo, 1 to <1.5/mo, 1.5 to <3.5/mo, 3.5/mo to <3/wk, and ≥3/wk had HRs (95% CIs) of 1.00 (referent), 1.17 (1.00, 1.36), 1.05 (0.90, 1.22), 1.09 (0.94, 1.25), and 1.27 (1.09, 1.49), respectively (P for linear trend = 0.005). No association was apparent for older women.

CONCLUSION:

We observed no association between chocolate intake and risk of CHD, stroke, or both combined in participants free of pre-existing major chronic disease. The relation for both combined was modified by age, with a significant positive linear trend and an increased risk in the highest quintile of chocolate consumption among women age <65 y.

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Fat Tissue Growth and Development in Humans.

Arner P.

Nestle Nutr Inst Workshop Ser. 2018;89:37-45. doi: 10.1159/000486491. Epub 2018 Jul 10.

PMID: 29991030

Abstract

Lipid storage and release from fat cells in adipose tissue are key factors in the regulation of the energy balance. During infancy and adolescence, adipose tissue is growing by a combination of increase in fat cell size (to a lesser extent) and (above all) the number of these cells. In adults, fat cell number is constant over time in spite of a large turnover (about 10% of the fat cells per year) when body weight is stable. A decrease in body weight only changes fat cell size (becoming smaller), whereas an increase in body weight causes elevation of both fat cell size and number in adults. An important source of renewal of fat cells during the entire life span is the bone marrow. This is most apparent in obesity when ∼20% of all fat cells are derived from the bone marrow. Fat cell turnover is also important for the size of fat cells. Low turnover may cause large fat cells which, in turn, is linked to cardiovascular disease and type 2 diabetes. There is also a rapid turnover of fat cell lipids, which constitute a single active pool and are renewed about 6 times during the life span of individual fat cells. Overweight and obesity are associated with decreased lipid turnover due to high input in combination with low output of lipids from the fat cells. Low fat cell lipid turnover is associated with insulin resistance and dyslipidemia. Thus, changes in the turnover of fat cells and their lipid content are important for the development of adipose tissue mass and its cellularity (fat cell size and number) and, in turn, for metabolic disturbances.

 

Is objectively measured light-intensity physical activity associated with health outcomes after adjustment for moderate-to-vigorous physical activity in adults? A systematic review.

Amagasa S, Machida M, Fukushima N, Kikuchi H, Takamiya T, Odagiri Y, Inoue S.

Int J Behav Nutr Phys Act. 2018 Jul 9;15(1):65. doi: 10.1186/s12966-018-0695-z. Review.

PMID: 29986718

https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-018-0695-z

Abstract

BACKGROUND:

An increasing number of studies have demonstrated that light-intensity physical activity (LPA) confers health benefits after adjustment for moderate-to-vigorous physical activity (MVPA). The purpose of this systematic review was to summarize existing epidemiological evidence on associations of objectively measured LPA with health outcomes in adults.

METHODS:

This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched on PubMed, Web of Science, CINAL, and Cochrane Library for articles analyzing the association between objectively determined LPA and health outcomes that were published up to January 2017. Data were extracted regarding authors, publication year, country of survey, study setting, number of participants, study design, physical activity (PA) assessment (type of accelerometer and intensity), health outcomes, confounders, and results (summary measures and association). A coding system was used to summarize the results.

RESULTS:

Of the 3254 studies identified, 24 cross-sectional and 6 longitudinal studies were included in this review. Most of the studies targeted the Western population. LPA was inversely associated with all-cause mortality risk and associated favorably with some cardiometabolic risk factors including waist circumference, triglyceride levels, insulin, and presence of metabolic syndrome. Only a small amount of data were available on mental health and cognitive function.

CONCLUSIONS:

LPA appears to be beneficially associated with important health outcomes after adjustment for MVPA in the adult population. Although current global PA guidelines recommend only MVPA, promoting LPA may confer additional health benefits.

KEYWORDS:

Accerelometry; Epidemiology; Lifestyle activity; Physical activity; Public health

 

Risk factors for inflammatory bowel disease: A prospective multi-center study.

Amarapurkar AD, Amarapurkar DN, Rathi P, Sawant P, Patel N, Kamani P, Rawal K, Baijal R, Sonawane A, Narawane N, Kolekar S, Totla N.

Indian J Gastroenterol. 2018 Jul 9. doi: 10.1007/s12664-018-0850-0. [Epub ahead of print]

PMID: 29987750

Abstract

INTRODUCTION:

Environmental risk factors have been associated with inflammatory bowel disease (IBD). With rising incidence, it is important to know risk factors associated with IBD in our population. This study was aimed to evaluate risk factors for IBD from western India.

METHODS:

This was prospective, multi-center case-control study which included 1054 patients with IBD of which 765 (72.5%) were ulcerative colitis (UC) and 289 (27.4%) Crohn's disease (CD). Asymptomatic individuals without a history of any major illness served as controls. The questionnaire containing risk factors for IBD was given to patients and control group. Odds ratio and 95% confidence interval were calculated for each variable.

RESULT:

Significant numbers of patients with CD were from rural area. Rural environment (OR 1.071, 0.82-1.38 and OR 1.441, 1.02-2.02), higher education (OR 1.830, 1.52-2.19 and OR 1.519, 1.16-1.97), professional by occupation (OR 1.754, 1.46-2.09 and OR 1.293, 0.99-1.67), annual family income >100,000 Indian national rupees (OR 2.185, 1.52-3.13 and OR 4.648, 3.10-6.95), history of appendectomy (OR 3.158, 1.71-5.80 and OR 3.158, 1.71-5.80), and family history of IBD (OR 4.510, 2.19-9.25 and OR 3.972, 1.58-9.96) were the risk factors for UC and CD, respectively. Vegetarian diet was protective factor for UC (OR 0.29, 0.27-0.39) and risk for CD (OR 1.179, 0.88-1.57). Smoking and chronic alcoholism were not found to be the risk factors.

CONCLUSION:

This study highlights association between socioeconomic, dietary factors, appendectomy, and family history as risk factors for IBD.

KEYWORDS:

Crohn’s disease; Extraintestinal manifestations; Ulcerative colitis

 

Intake of glucosinolates and risk of coronary heart disease in three large prospective cohorts of US men and women.

Ma L, Liu G, Zong G, Sampson L, Hu FB, Willett WC, Rimm EB, Manson JE, Rexrode KM, Sun Q.

Clin Epidemiol. 2018 Jun 29;10:749-762. doi: 10.2147/CLEP.S164497. eCollection 2018.

PMID: 29988715

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029595/pdf/clep-10-749.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029595/table/ts5-clep-10-749/?report=objectonly

Abstract

IMPORTANCE:

Glucosinolates, a group of phytochemicals abundant in cruciferous vegetables, may have cardioprotective properties. However, no prospective study has evaluated the association of intake of glucosinolates with the risk of coronary heart disease (CHD).

OBJECTIVE:

The objective of the study was to evaluate the association between the intake of glucosinolates and incident CHD in US men and women.

DESIGN:

Prospective longitudinal cohort study.

SETTING:

Health professionals in the USA.

PARTICIPANTS:

We followed 74,241 women in the Nurses' Health Study (NHS; 1984-2012), 94,163 women in the NHSII (1991-2013), and 42,170 men in the Health Professionals Follow-Up Study (1986-2012), who were free of cardiovascular disease and cancer at baseline.

EXPOSURE:

Glucosinolate intake was assessed using validated semi-quantitative food frequency questionnaires at baseline and updated every 2-4 years during follow-up.

MAIN OUTCOME MEASURES:

Incident cases of CHD were confirmed by medical record review.

RESULTS:

During 4,824,001 person-years of follow-up, 8,010 cases of CHD were identified in the three cohorts. After adjustment for major lifestyle and dietary risk factors of CHD, weak but significantly positive associations were observed for glucosinolates with CHD risk when comparing the top with bottom quintiles (hazard ratio {HR}:1.09; 95% CI: 1.01, 1.17; Ptrend<0.001). Higher intakes of three major subtypes of glucosinolates were consistently associated with a higher CHD risk, although the association for indolylglucosinolate did not achieve statistical significance. Regarding cruciferous vegetable intake, participants who consumed one or more servings per week of Brussels sprouts (HR: 1.16; 95% CI: 1.06, 1.26; P<0.001) and cabbage (HR: 1.09; 95% CI: 1.02, 1.17; P=0.009) had a significantly higher CHD risk than those who consumed these cruciferous vegetables less than once per month.

CONCLUSION AND RELEVANCE:

In these three prospective cohort studies, dietary glucosinolate intake was associated with a slightly higher risk of CHD in US adults. These results warrant replications in further studies including biomarker-based studies. Further studies are needed to confirm these findings and elucidate mechanistic pathways that may underlie these associations.

KEYWORDS:

coronary heart disease; cruciferous vegetable; diet; glucosinolate

 

Intake of folate and other nutrients related to one-carbon metabolism and risk of cutaneous melanoma among US women and men.

Dhana A, Yen H, Li T, Holmes MD, Qureshi AA, Cho E.

Cancer Epidemiol. 2018 Jul 7;55:176-183. doi: 10.1016/j.canep.2018.06.006. [Epub ahead of print]

PMID: 29990794

Abstract

BACKGROUND:

Nutrients involved in one-carbon metabolism - folate, vitamins B6 and B12, methionine, choline, and betaine - have been inversely associated with multiple cancer sites and may be related to skin cancer. However, there is a lack of research on the association between intake of these nutrients and cutaneous melanoma risk. The aim of this study was to examine the associations between intake of one-carbon metabolism nutrients and cutaneous melanoma risk in two large prospective cohorts.

METHODS:

The cohorts included 75,311 white women and 48,523 white men. Nutrient intake was assessed repeatedly by food frequency questionnaires and self-reported supplement use. We used Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) and then pooled HRs using a random-effects model.

RESULTS:

Over 24-26 years of follow-up, we documented 1328 melanoma cases (648 men and 680 women). Higher intake of folate from food only, but not total folate, was associated with increased melanoma risk (pooled HR for top versus bottom quintile: 1.36; 95% CI: 1.13-1.64; P for trend = 0.001). The association was significant in men, but attenuated in women. Higher intake of vitamins B6 and B12, choline, betaine, and methionine were not associated with melanoma risk, although there was modest increasing trend of risk for vitamin B6 from food only (pooled HR for top versus bottom quintile: 1.18; 95% CI: 0.99-1.41; P for trend = 0.03).

CONCLUSIONS:

We found some evidence that higher intake of folate from food only was associated with a modest increased risk of cutaneous melanoma. However, since other factors related to dietary folate intake may account for the observed association, our findings warrant further investigation.

KEYWORDS:

Betaine; Choline; Folate; Melanoma; Methionine; One-carbon metabolism; Prospective study; Skin neoplasms; Vitamin B12; Vitamin B6

 

Effects of Nutrition on the Development of Higher-Order Cognition.

Willatts P.

Nestle Nutr Inst Workshop Ser. 2018;89:175-184. doi: 10.1159/000486501. Epub 2018 Jul 10.

PMID: 29991041

Abstract

The long-chain polyunsaturated fatty acids (LC-PUFAs) docosahexaenoic acid (DHA) and arachidonic acid (ARA) occur in high levels in the brain and play a key role in brain growth and the operation of neurotransmitters. Infants supplemented with DHA show improved language and communication skills, and there is accumulating evidence that the early development of executive functions such as planning, working memory, and attention control are influenced by LC-PUFAs, especially DHA. Several studies have found significantly improved means-end problem solving at 9 and 10 months in infants given DHA-/ARA-supplemented formula, and similar results were shown for infants whose mothers were supplemented with DHA during pregnancy and breastfeeding. Long-term benefits of LC-PUFA supplementation in infancy have been reported in children aged 3-6 years. Follow-up studies of infants given DHA-/ARA-supplemented versus control formula have shown better performance on tests of impulsivity and attention control in the supplemented children, with indications of a dose-response relationship for DHA. LC-PUFAs (especially DHA) in postnatal infant diet influence the development of executive functions and other higher-order cognitive abilities, and have a long-term influence on the development of attention and information processing in later childhood.

Edited by AlPater

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Objectively measured habitual physical activity and sleep-related phenomena in 1645 people aged 1-91 years: The Nakanojo Community Study.

Aoyagi Y, Park S, Cho S, Shephard RJ.

Prev Med Rep. 2018 Jun 26;11:180-186. doi: 10.1016/j.pmedr.2018.06.013. eCollection 2018 Sep.

PMID: 29992084

https://www.sciencedirect.com/science/article/pii/S2211335518301098?via%3Dihub

https://reader.elsevier.com/reader/sd/044A3B50B66ECAFCC2E980CAAF4E406B987281C433A0E286158494F93A3A98FA38520F307D7011FA8DDDFE0F712558EE

Abstract

Relationships between habitual physical activity and sleep-related phenomena were examined in 623 male and 1022 female Japanese participating in the Nakanojo Community Study, using data collected in 2012-2013. Ages ranged from infancy to very old. Daily step count and daily duration of exercise at an intensity >3 metabolic equivalents (METs) were determined by pedometer/accelerometer, 24 h/day for 1 week. Duplicate axillary temperatures were also taken on rising and when retiring. Total bed time was noted, and the efficiency of sleep determined as hours of actual sleep (from a validated pedometer/accelerometer algorithm) divided by bed time. Step counts and especially duration of activity >3 METs peaked in teenagers and decreased as age advanced (p < 0.001). Both axillary temperatures subsequently showed a gradual age-related decline (p < 0.001). The duration and efficiency of sleep also showed a small age-dependent decrease (p < 0.001). Multivariate-adjusted correlation coefficients indicated a better quality of sleep in individuals who took greater habitual physical activity. In individuals aged ≥40 years, these findings were modified by chronic disease conditions including hypertension, diabetes mellitus and hyperlipemia; after controlling statistically for potential confounders, both physical activity and axillary temperature were lower (p < 0.05 or 0.01), and the time spent lying was longer but the efficiency of sleep was poorer (p < 0.01) in those with chronic conditions. These results suggest that habitual physical activity bears an important relationship to sleep-related phenomena at all ages, with a modification of relationships by chronic disease in people aged ≥40 years.

KEYWORDS:

Axillary temperature; Chronic illness; Moderate-intensity exercise; Sleep efficiency; Step count

 

Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis.

Kim J, Choi J, Kwon SY, McEvoy JW, Blaha MJ, Blumenthal RS, Guallar E, Zhao D, Michos ED.

Circ Cardiovasc Qual Outcomes. 2018 Jul;11(7):e004224. doi: 10.1161/CIRCOUTCOMES.117.004224.

PMID: 29991644

Abstract

BACKGROUND:

Multiple studies have attempted to identify the association between multivitamin/mineral (MVM) supplementation and cardiovascular disease (CVD) outcomes, but the benefits remain controversial. We performed a systematic review and meta-analysis of the associations between MVM supplementation and various CVD outcomes, including coronary heart disease (CHD) and stroke.

METHODS AND RESULTS:

We conducted a comprehensive search of Medline, Embase, and the Cochrane Library for studies published between January 1970 and August 2016. We included clinical trials and prospective cohort studies in the general population evaluating associations between MVM supplementation and CVD outcomes. Data extraction and quality assessment were independently conducted by 2 authors, and a third author resolved discrepancies. Eighteen studies with 2 019 862 participants and 18 363 326 person-years of follow-up were included in the analysis. Five studies specified the dose/type of MVM supplement and the rest did not. Overall, there was no association between MVM supplementation and CVD mortality (relative risk [RR], 1.00; 95% confidence interval [CI], 0.97-1.04), CHD mortality (RR, 1.02; 95% CI, 0.92-1.13), stroke mortality (RR, 0.95; 95% CI, 0.82-1.09), or stroke incidence (RR, 0.98; 95% CI, 0.91-1.05). There was no association between MVM supplements and CVD or CHD mortality in prespecified subgroups categorized by mean follow-up period, mean age, period of MVM use, sex, type of population, exclusion of patients with history of CHD, and adjustment for diet, adjustment for smoking, adjustment for physical activity, and study site. In contrast, MVM use did seem to be associated with a lower risk of CHD incidence (RR, 0.88; 95% CI, 0.79-0.97). However, this association did not remain significant in the pooled subgroup analysis of randomized controlled trials (RR, 0.97; 95% CI, 0.80-1.19).

CONCLUSIONS:

Our meta-analysis of clinical trials and prospective cohort studies demonstrates that MVM supplementation does not improve cardiovascular outcomes in the general population.

KEYWORDS:

cardiovascular diseases; coronary disease; incidence; mortality; myocardial infarction; stroke

 

Alcohol consumption and risk of gastric cardia adenocarcinoma and gastric non-cardia adenocarcinoma: A 16-year prospective analysis from the NIH-AARP Diet and Health cohort.

Wang S, Freedman ND, Loftfield E, Hua X, Abnet CC.

Int J Cancer. 2018 Jul 11. doi: 10.1002/ijc.31740. [Epub ahead of print]

PMID: 29992560

Abstract

The role of alcoholic beverages in the etiology of gastric cancer is unclear. Recent summaries showed a positive association between higher alcohol intake and gastric cancer risk, but the magnitude of association is small, there is moderate heterogeneity among studies, and most cases were from Asian populations. We prospectively investigated the associations of alcohol consumption with gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA) in 490,605 adults, aged 50-71 years at baseline who participated in the NIH-AARP Diet and Health Study. Alcohol consumption in the past year was assessed at baseline by questionnaire and defined as total grams of ethanol intake per day or as a categorical variable: non-drinker, up to or including one drink/day, one to three drinks/day, and greater than three drinks/day. We used multivariable-adjusted Cox proportional hazards regression to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for associations between alcohol intake and risk of gastric adenocarcinomas. Through 2011, 662 incident cases of GCA and 713 of GNCA occurred. We found no association between higher alcohol consumption and GCA or GNCA, when examined as total alcoholic beverage intake individual beverage types of beer, wine and liquor. Furthermore, we observed no association by stratum of sex, ethnic group, educational level, or smoking status. We did, however, observe lower risk of GNCA among participants who drank up to one drink per day (HR=0.81, 95%CIs:0.67-0.97) compared to nondrinkers. In conclusion, alcohol consumption was not associated with increased risk of GCA or GNCA in this large US cohort.

KEYWORDS:

NIH-AARP; alcohol; gastric cardia adenocarcinoma; gastric non-cardia adenocarcinoma; prospective analysis

 

Effects of EPA and DHA on blood pressure and inflammatory factors: a meta-analysis of randomized controlled trials.

Guo XF, Li KL, Li JM, Li D.

Crit Rev Food Sci Nutr. 2018 Jul 11:1-31. doi: 10.1080/10408398.2018.1492901. [Epub ahead of print]

PMID: 29993265

Abstract

The present study aimed to clarify whether eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have differential effects on blood pressure and inflammatory mediators. A systematic literature search was conducted in PubMed and Scopus updated to Apr. 2018. The mean changes in risk factors of chronic diseases were calculated as weighted mean difference (WMD) by using a random-effects model. Twenty randomized controlled trials (RCTs) were included. The summary estimate showed that EPA intervention significantly reduced systolic blood pressure (SBP) (-2.6 mmHg; 95%confident interval (CI): -4.6, -0.5 mmHg), especially in subjects with dyslipidemia (-3.8 mmHg; 95%CI: -6.7, -0.8 mmHg). The pooled effect indicated that supplemental DHA exerted a significant reduction in diastolic blood pressure (DBP) in subjects with dyslipidemia (-3.1 mmHg; 95%CI: -5.9, -0.2 mmHg). Both EPA (-0.56 mg/L; 95%CI: -1.13, 0.00) and DHA (-0.5 mg/L; 95%CI: -1.0, -0.03) significantly reduced the concentrations of C-reactive protein (CRP), respectively, especially in subjects with dyslipidemia and higher baseline CRP concentrations. Given that limited trials have focused on EPA or DHA intervention on concentrations of interleukin (IL)-6 and tumor necrosis factor (TNF)-α, further RCTs should be explored on these inflammatory factors. The present meta-analysis provides substantial evidence that EPA and DHA have independent (blood pressure) and shared (CRP concentration) effects on risk factors of chronic diseases, and high-quality RCTs with multi-center and large simple-size should be performed to confirm the present findings.

KEYWORDS:

Blood pressure; Docosahexaenoic acid; Eicosapentaenoic acid; Inflammatory factors; Randomized controlled trial

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Complexity of the relationship between life expectancy and overlap of lifespans.

Barthold Jones JA, Lenart A, Baudisch A.

PLoS One. 2018 Jul 12;13(7):e0197985. doi: 10.1371/journal.pone.0197985. eCollection 2018.

PMID: 30001385

Abstract

Longevity has long been recognised as a key facilitator of reciprocal altruism because repeated cooperation of partners hinges on mutual survival. Although demographic tools can be used to quantify mutual survival and expected overlapping lifespans, studies on the evolutionary theory of cooperation take only limited advantage of demography. Overlap of lifespans depends on variation in survival across ages and can be high or low independently of high or low life expectancies. Here we develop formal demographic measures to study the complex relationships between shared life expectancy of two birth cohort peers, the proportion of their lives that they can expect to overlap, and longevity. We simulate age-specific mortality schedules using a Siler model to reveal how infant and senescent mortality, along with age-independent mortality, affect the relationship between the proportion of life shared and life expectancy. We find that while the proportion of life shared can vary vastly for similar life expectancies, almost all changes to mortality schedules that result in higher life expectancies also result in higher proportions of life shared. A distinct exception occurs if life expectancy increases due to lowering the rate of senescence. In this case the proportion of life shared decreases. Our work shows that almost all selective pressures that result in higher life expectancies also result in a larger proportion of life shared. Therefore, selective forces that extend life also improve the chances that a cooperative system would be stable in terms of reciprocal interactions. Since reciprocal interactions may also reduce mortality and result in a feedback loop with the evolution of longevity, our measures and findings can be used for future cross-species comparisons that aim to disentangle predecessor and successor in the evolution of longevity and cooperation.

 

Controversy on the correlation of red and processed meat consumption with colorectal cancer risk: An Asian perspective.

Hur SJ, Jo C, Yoon Y, Jeong JY, Lee KT.

Crit Rev Food Sci Nutr. 2018 Jul 12:1-50. doi: 10.1080/10408398.2018.1495615. [Epub ahead of print]

PMID: 29999423

Abstract

This study aimed to investigate the relationship between meat intake and colorectal cancer risk from an Asian, particularly Korean, perspective. A report by the International Agency for Research on Cancer (IARC) published in 2015 concluded that intake of processed and red meat increases the risk of developing colorectal cancer. We conducted an in-depth analysis of prospective, retrospective, case-control and cohort studies, systematic review articles, and IARC monograph reports, which revealed that the IARC/WHO report weighted the results of studies based in Western countries more and that the correlation between intake of processed meat products and colorectal cancer incidence in Asians is not clearly supported. Among 73 epidemiological studies, approximately 76% were conducted in Western countries, whereas only 15% of studies were conducted in Asia. Furthermore, most studies conducted in Asia showed that processed meat consumption is not related to the onset of cancer. Moreover, there have been no reports showing significant correlation between various factors that directly or indirectly affect colorectal cancer incidence, including processed meat products types, raw meat types, or cooking methods. Further epidemiological studies taking each country's food culture into consideration are required to reliably elucidate the effects of processed meat product intake, especially on cancer incidence.

KEYWORDS:

Safety assessment; cohort study; colorectal cancer; meat consumption

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Autophagy as a promoter of longevity: insights from model organisms.

Hansen M, Rubinsztein DC, Walker DW.

Nat Rev Mol Cell Biol. 2018 Jul 13. doi: 10.1038/s41580-018-0033-y. [Epub ahead of print] Review.

PMID: 30006559

https://sci-hub.tw/

Abstract

Autophagy is a conserved process that catabolizes intracellular components to maintain energy homeostasis and to protect cells against stress. Autophagy has crucial roles during development and disease, and evidence accumulated over the past decade indicates that autophagy also has a direct role in modulating ageing. In particular, elegant studies using yeasts, worms, flies and mice have demonstrated a broad requirement for autophagy-related genes in the lifespan extension observed in a number of conserved longevity paradigms. Moreover, several new and interesting concepts relevant to autophagy and its role in modulating longevity have emerged. First, select tissues may require or benefit from autophagy activation in longevity paradigms, as tissue-specific overexpression of single autophagy genes is sufficient to extend lifespan. Second, selective types of autophagy may be crucial for longevity by specifically targeting dysfunctional cellular components and preventing their accumulation. And third, autophagy can influence organismal health and ageing even non-cell autonomously, and thus, autophagy stimulation in select tissues can have beneficial, systemic effects on lifespan. Understanding these mechanisms will be important for the development of approaches to improve human healthspan that are based on the modulation of autophagy.

 

Effects of oils and solid fats on blood lipids: a systematic review and network meta-analysis.

Schwingshackl L, Bogensberger B, Bencic A, Knueppel S, Boeing H, Hoffmann G.

J Lipid Res. 2018 Jul 13. pii: jlr.P085522. doi: 10.1194/jlr.P085522. [Epub ahead of print]

PMID: 30006369

https://sci-hub.tw/

Abstract

The aim of this network meta-analysis (NMA) is to compare the effects of different oils/solid fats on blood lipids. Literature searches were performed until March 2018. Inclusion criteria were as follows: i) Randomized trial (≥3 weeks study length) comparing at least two of the following oils/ solid fats: safflower-, sunflower-, rapeseed-, hempseed-, flaxseed-, corn-, olive-, soybean-, palm-, coconut-oil, lard, beef-fat, and butter; ii) LDL-cholesterol (LDL-C), total cholesterol (TC), HDL-cholesterol (HDL-C), and triacyglycerols (TG). A random dose-response (per 10% iso-caloric exchange) NMA was performed and surface under the cumulative ranking curve (SUCRA) was estimated. 54 trials were included in the NMA. Safflower-oil had the highest SUCRA value for LDL-C (82%) and TC (90%), followed by rapeseed-oil (76% for LDL-C, 85% for TC), whereas palm oil (74%) had the highest SUCRA value for TG, and coconut-oil (88%) for HDL-C. Safflower-, sunflower-, rapeseed-, flaxseed-, corn-, olive-, soybean-, palm-, and coconut-oil as well beef fat were more effective in reducing LDL-C (-0.42 mmol/l to -0.23 mmol/l) as compared to butter. Despite limitations in these data, our NMA findings are in line with existing evidence on metabolic effects of fat, and support current recommendations to replace high saturated-fat food with unsaturated oils.

KEYWORDS:

Cholesterol/dietary; Clinical trials; Dyslipidemias; Epidemiology; Fatty acid; Heart; LDL; network meta-analysis; oils; solid fats

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Here's what 50 years of food supply data says about Canada's eating habits

The meat and potatoes of Canadian meals look more like chicken and rice

Roberto Rocha · CBC News · Posted: Jul 17, 2018

http://www.cbc.ca/news/canada/montreal/canada-food-trends-1.4742309

 

Reaching 100 in the Countryside: Health Profile and Living Circumstances of Portuguese Centenarians from the Beira Interior Region.

Afonso RM, Ribeiro O, Vaz Patto M, Loureiro M, Loureiro MJ, Castelo-Branco M, Patrício S, Alvarinhas S, Tomáz T, Rocha C, Jerónimo AM, Gouveia F, Amaral AP.

Curr Gerontol Geriatr Res. 2018 Jun 13;2018:8450468. doi: 10.1155/2018/8450468. eCollection 2018.

PMID: 30008746

https://www.hindawi.com/journals/cggr/2018/8450468/

Abstract

The interest in studying a specific population of centenarians who lives in the country's interior region (PT100-BI) emerged during the first Portuguese systematic study about centenarians (PT100 Oporto Centenarian Study). This region of Portugal is predominantly rural and is one of the regions with the largest number of aged people. The aim of this study is to provide information on the centenarians who live in the Beira Interior region, specifically in terms of their health status and the health services they use. A total of 101 centenarians (mean age: 101.1 years; SD = 1.5 years), 14 males and 87 females, were considered. Most centenarians lived in the community, and 47.6% lived in nursing homes. Nearly half (47.5%) presented cognitive functioning without deficits. A noteworthy percentage presented conditioned mobility and sensory problems. The most common self-reported diseases include urinary incontinence (31.7%), high blood pressure (23.8%), and heart conditions (19.8%). Despite these health and functional characteristics, formal support services and technical assistance were found to be scarcely used. Further research is needed to understand how the role of contextual variables and the countryside environment contribute to the centenarians' adaptation to advanced longevity.

 

Physical activity and all-cause mortality in Korean older adults.

Cho J, Lee I, Park S, Jin Y, Kim D, Kim S, Kang H.

Ann Hum Biol. 2018 Jul 16:1-9. doi: 10.1080/03014460.2018.1478448. [Epub ahead of print]

PMID: 30010426

Abstract

BACKGROUND:

The association between physical activity (PA) and all-cause mortality may be modulated by potential confounders.

AIM:

To investigate the association between weekly PA and all-cause mortality in a population-based prospective study.

SUBJECTS AND METHODS:

The study sample included Korean older adults aged 60 years and older who participated in baseline assessments (n = 15 416) in 2008 and completed follow-up visits in 2011 (n = 14,976). Primary outcome was 3-year all-cause mortality.

RESULTS:

Compared with sufficiently active individuals (with Hazard Ratio (HR) = 1), completely inactive and insufficiently active individuals had a significantly higher risk of all-cause mortality (HR = 2.086, 95% CI = 1.639-2.655, p < 0.00 and HR = 1.644, 95% CI = 1.013-2.668, p = 0.044, respectively), even after adjustments for age and sex, health-related behaviour factors (i.e. smoking, alcohol intake and nutritional risk), cognitive impairment and components of frailty phenotype (i.e. involuntary weight loss, exhaustion and slowness). In addition, the inverse association between PA and all-cause mortality is differently modulated by potential confounders, including age, sex, smoking, depressive symptoms, cognitive impairment and involuntary weight loss.

CONCLUSION:

PA was inversely and independently associated with all-cause mortality in Korean older adults.

KEYWORDS:

Physical activity; geriatrics; health behaviours; premature death

 

Dietary sugar intake does not pose any risk of bone loss and non-traumatic fracture and is associated with a decrease in all-cause mortality among Chinese elderly: Finding from an 11-year longitudinal study of Mr. and Ms. OS Hong Kong.

Liu ZM, Tse SLA, Chen B, Chan D, Wong C, Woo J, Wong SY.

Bone. 2018 Jul 13. pii: S8756-3282(18)30268-0. doi: 10.1016/j.bone.2018.07.011. [Epub ahead of print]

PMID: 30010084

Abstract

BACKGROUND:

The association of dietary sugar intake and skeletal health remains uncertain in the elderly. We aimed to investigate the association of sugar intake with the bone health and mortality of Chinese elderly.

METHODS:

An analysis was conducted through an 11-year longitudinal study (Mr. and Ms. OS Hong Kong). Four thousand Chinese elderly aged 65 and older were recruited from the local community between 2001 and 2003. Sugar intake was assessed at baseline by a validated 329-item Food Frequency Questionnaire and a local sugar database. The bone mineral density (BMD) was examined at baseline and the fourth year follow-up by a dual-energy X-ray absorptiometry. Data on the incidence of non-traumatic fractures (total, hip and osteoporotic sites) and all-cause mortality were collected. The multivariable logistic and Cox regression models were used to test the associations of sugar intake with bone health and all-cause mortality.

RESULTS:

No significant association was observed between sugar intakes and BMD changes in the fourth year's follow-up. During a total 34,483 person years' follow-up, we documented 433 non-traumatic fractures and 769 deaths. Although lack of significant association with the incidence of non-traumatic fractures, high added sugar intakes were significantly associated with a low risk of all-cause mortality among the elderly with a hazard ratio of 0.750 (95% CI: 0.590-0.954, P for trend = 0.007) in the highest quintile compared with that in the lowest quintile.

CONCLUSION:

The amount of sugar consumed by the Chinese elderly did not pose any risk of bone loss and fracture. Moreover, high sugar intake of the elderly was associated with a low rate of all-cause mortality.

KEYWORDS:

All-cause mortality; Bone mineral density; Chinese elderly; Fracture; Sugar intake

[see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985213/also.]

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Solar energy at birth and human lifespan.

Davis GE Jr, Lowell WE.

J Photochem Photobiol B. 2018 Jul 5;186:59-68. doi: 10.1016/j.jphotobiol.2018.07.006. [Epub ahead of print]

PMID: 30015061

https://sci-hub.tw/

Abstract

PURPOSE:

The purpose of this paper is to examine the role of UVR at birth and its relationship to lifespan and determine whether there are significant differential effects on sex and race. We test if variation in UVR, as determined by solar cycles (long-term variation), is related to survival as measured by age at death.

METHODS:

The data used 78 million death records from the National Center for Health Statistics (NCHS) from 1979 to 2013 with accidents, suicides, and war casualties deleted resulted in ~63 million records. Records of persons ≤ 47 years old were also scrubbed because we could not show an effect on lifespan based upon the intensity of solar energy as reflected by sunspot number (SSN). This we hypothesize is due to the protective effect of the hormones associated with growth and reproduction. Also selected were persons afflicted with multiple sclerosis (MS).

RESULTS:

Males of all races born with a UVR intensity as estimated by sunspot number (SSN) ≤ 90 had an average lifespan of 74.4 years, for females of all races, 78.1 years; males born with >90 had an average lifespan of 66.3 years, for females of all races, 70.2 years, resulting in a lifespan decrease of 8.1 years for males and 8.5 years for females. For African-American males born ≤ 90 SSN, 70.8 years and for >90 SSN, 62.5 years, an 8.3-year decrease; similarly, for African-American females ≤ 90 SSN, 75.0, for >90 SSN, 65.4 years, a 9.6-year decrease. Higher solar energy at birth had an adverse effect on human lifespan. We also found that there were twice as many persons with MS born in >80-90 SSN as in the general population.

CONCLUSIONS:

There is a statistically significant inverse relationship between exposure to solar energy at birth and average human lifespan. Solar energy by some mechanism alters the epigenome at birth, but the effect of higher solar energy becomes apparent after the age of natural selection.

KEYWORDS:

Epigenetics; Human lifespan; Multiple sclerosis; Solar energy; Sunspot number; Ultraviolet radiation

 

Effect of Supplementation of a Whey Peptide Rich in Tryptophan-Tyrosine-Related Peptides on Cognitive Performance in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Study.

Kita M, Obara K, Kondo S, Umeda S, Ano Y.

Nutrients. 2018 Jul 13;10(7). pii: E899. doi: 10.3390/nu10070899.

PMID: 30011836

Abstract

Background: Previous epidemiological and clinical studies have shown that dairy products have beneficial effects on cognitive decline and dementia. Enzymatic digestion of whey protein produces a whey peptide rich in tryptophan-tyrosine-related peptides which improve cognitive performance in mice. We evaluated the effects of whey peptides on cognitive functions in healthy adults in a randomized, double-blind, placebo-controlled design. Methods: 101 healthy adults (45 to 64 years), with a self-awareness of cognitive decline received either whey peptide or placebo supplements for 12 weeks. Changes in cognitive function were assessed using neuropsychological tests at 6 and 12 weeks after the start of supplementation. Results: Verbal fluency test (VFT) score changes tended to be higher in the whey peptide group compared with the placebo at 12 weeks. Subgroup analysis classified by the degree of subjective fatigue showed that changes in the VFT as well as the Stroop and subjective memory function tests between baseline and 6 weeks of intervention were significantly better in subjects with high-level fatigue from the whey peptide group as compared to the placebo group.

CONCLUSIONS:

Intake of whey peptide might improve cognitive function in healthy middle- and older-aged adults with high subjective fatigue levels. Further studies will elucidate the relationship among cognitive improvement, whey peptides, and psychological fatigue.

KEYWORDS:

cognitive function; dairy food; whey peptide

 

 

A Review on the Effects of Bisphenol A and Its Derivatives on Skeletal Health.

Chin KY, Pang KL, Mark-Lee WF.

Int J Med Sci. 2018 Jun 22;15(10):1043-1050. doi: 10.7150/ijms.25634. eCollection 2018. Review.

PMID: 30013446

Abstract

Bisphenol A (BPA) is an endocrine disruptor which can bind to the oestrogen receptor. It also possesses oestrogenic, antiandrogenic, inflammatory and oxidative properties. Since bone responds to changes in sex hormones, inflammatory and oxidative status, BPA exposure could influence bone health in humans. This review aimed to summarize the current evidence on the relationship between BPA and bone health derived from cellular, animal and human studies. Exposure to BPA (0.5-12.5 µM) decreased the proliferation of osteoblast and osteoclast precursor cells and induce their apoptosis. Bisphenol AF (10 nM) enhanced transforming growth factor beta signalling but bisphenol S (10 nM) inhibited Wnt signalling involved in osteoblast differentiation in vitro. In animals, BPA and its derivatives demonstrated distinct effects in different models. In prenatal/postnatal exposure, BPA increased femoral bone mineral content in male rats (at 25 ug/kg/day) but decreased femoral mechanical strength in female mice (at 10 µg/kg/day). In oestrogen deficiency models, BPA improved bone mineral density and microstructures in aromatase knockout mice (at very high dose, 0.1% or 1.0% w/w diet) but decreased trabecular density in ovariectomized rats (at 37 or 370 ug/kg/day). In contrast, bisphenol A diglycidyl ether (30 mg/kg/day i.p.) improved bone health in normal male and female rodents and decreased trabecular separation in ovariectomized rodents. Two cross-sectional studies have been performed to examine the relationship between BPA level and bone mineral density in humans but they yielded negligible association. As a conclusion, BPA and its derivatives could influence bone health and a possible gender effect was observed in animal studies. However, its effects in humans await verification from more comprehensive longitudinal studies in the future.

KEYWORDS:

Bone; Endocrine discruptor; Oestrogen; Osteoporosis; Xenoestrogen

 

Relationship Between Meal Frequency and Gastroesophageal Reflux Disease (GERD) in Iranian Adults.

Vakhshoori M, Keshteli AH, Saneei P, Esmaillzadeh A, Adibi P.

Dig Dis Sci. 2018 Jul 16. doi: 10.1007/s10620-018-5200-7. [Epub ahead of print]

PMID: 30014224

Abstract

BACKGROUND:

The association between frequency of meals and snacks and gastroesophageal reflux disease (GERD) is less studied in Middle-Eastern countries.

AIM:

We aimed to determine the relationship between meal and snack frequency with GERD symptoms in a large sample of Iranian adults.

METHODS:

In this cross-sectional study, 4669 individuals filled out a questionnaire about their number of meals and snacks. Frequency of total meals was defined by summing up the frequency of main meals and snacks, and participants were categorized into four categories: < 3, 3-5, 6-7 and ≥ 8 meals/day. GERD was defined as having heartburn sometimes or more during the last 3 months. The severity of disease was assessed.

RESULTS:

The prevalence of GERD in the study population was 23.7%. There was no significant association between meal or snack frequency and GERD symptoms in the whole population. However, after adjustment of all potential confounders, we found that women who consumed 1-2 or 3-5 snacks per day, compared with those who never had snacks, had a 41% (OR 0.59; 95% CI 0.42-0.84) and 51% (OR 0.49; 95% CI 0.32-0.75) reduced risk of having GERD, respectively. Women who consumed 6-7 or ≥ 8 snacks and meals per day had a 38% (OR 0.62; 95% CI 0.41-0.96) and 43% (OR 0.57; 95% CI 0.34-0.95) risk reduction for GERD compared with those who ate < 3 snacks and meals per day.

CONCLUSION:

We found no significant association between meal frequency and GERD symptoms in the whole population. Gender-specific analysis revealed inverse associations between meal and snack frequency and GERD in Iranian women. Further prospective studies are required to confirm these associations.

KEYWORDS:

Feeding behavior; Gastroesophageal reflux; Meal frequency; Snack frequency

 

Height and body fatness and colorectal cancer risk: an update of the WCRF-AICR systematic review of published prospective studies.

Abar L, Vieira AR, Aune D, Sobiecki JG, Vingeliene S, Polemiti E, Stevens C, Greenwood DC, Chan DSM, Schlesinger S, Norat T.

Eur J Nutr. 2018 Aug;57(5):1701-1720. doi: 10.1007/s00394-017-1557-1. Epub 2017 Oct 28. Review.

PMID: 29080978 Free Article

Abstract

PURPOSE:

There is no published dose-response meta-analysis on the association between height and colorectal cancer risk (CRC) by sex and anatomical sub-site. We conducted a meta-analysis of prospective studies on the association between height and CRC risk with subgroup analysis and updated evidence on the association between body fatness and CRC risk.

METHODS:

PubMed and several other databases were searched up to November 2016. A random effects model was used to calculate dose-response summary relative risks (RR's).

RESULTS:

47 studies were included in the meta-analyses including 50,936 cases among 7,393,510 participants. The findings support the existing evidence regarding a positive association of height, general and abdominal body fatness and CRC risk. The summary RR were 1.04 [95% (CI)1.02-1.05, I² = 91%] per 5 cm increase in height, 1.02 [95% (CI)1.01-1.02, I² = 0%] per 5 kg increase in weight, 1.06 [95% (CI)1.04-1.07, I² = 83%] per 5 kg/m2 increase in BMI, 1.02 [95% (CI)1.02-1.03, I² = 4%] per 10 cm increase in waist circumference, 1.03 [95% (CI)1.01-1.05, I² = 16%] per 0.1 unit increase in waist to hip ratio. The significant association for height and CRC risk was similar in men and women. The significant association for BMI and CRC risk was stronger in men than in women.

CONCLUSION:

The positive association between height and risk of CRC suggests that life factors during childhood and early adulthood might play a role in CRC aetiology. Higher general and abdominal body fatness during adulthood are risk factors of CRC and these associations are stronger in men than in women.

KEYWORDS:

BMI; Colorectal cancer; Continuous update project; Height; Meta-analysis

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Omega-6 fats for the primary and secondary prevention of cardiovascular disease.

Hooper L, Al-Khudairy L, Abdelhamid AS, Rees K, Brainard JS, Brown TJ, Ajabnoor SM, O'Brien AT, Winstanley LE, Donaldson DH, Song F, Deane KH.

Cochrane Database Syst Rev. 2018 Jul 18;7:CD011094. doi: 10.1002/14651858.CD011094.pub3. [Epub ahead of print] Review.

PMID: 30019765

Abstract

BACKGROUND:

Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovascular disease (CVD) risk is debated.

OBJECTIVES:

To assess effects of increasing omega-6 fats (linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA)) on CVD and all-cause mortality.

SEARCH METHODS:

We searched CENTRAL, MEDLINE and Embase to May 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA:

We included randomised controlled trials (RCTs) comparing higher versus lower omega-6 fat intake in adults with or without CVD, assessing effects over at least 12 months. We included full texts, abstracts, trials registry entries and unpublished studies. Outcomes were all-cause mortality, CVD mortality, CVD events, risk factors (blood lipids, adiposity, blood pressure), and potential adverse events. We excluded trials where we could not separate omega-6 fat effects from those of other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS:

Two authors independently screened titles/abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias of included trials. We wrote to authors of included studies. Meta-analyses used random-effects analysis, while sensitivity analyses used fixed-effects and limited analyses to trials at low summary risk of bias. We assessed GRADE quality of evidence for 'Summary of findings' tables.

MAIN RESULTS:

We included 19 RCTs in 6461 participants who were followed for one to eight years. Seven trials assessed the effects of supplemental GLA and 12 of LA, none DGLA or AA; the omega-6 fats usually displaced dietary saturated or monounsaturated fats. We assessed three RCTs as being at low summary risk of bias.Primary outcomes: we found low-quality evidence that increased intake of omega-6 fats may make little or no difference to all-cause mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.88 to 1.12, 740 deaths, 4506 randomised, 10 trials) or CVD events (RR 0.97, 95% CI 0.81 to 1.15, 1404 people experienced events of 4962 randomised, 7 trials). We are uncertain whether increasing omega-6 fats affects CVD mortality (RR 1.09, 95% CI 0.76 to 1.55, 472 deaths, 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997 randomised, 7 trials), major adverse cardiac and cerebrovascular events (RR 0.84, 95% CI 0.59 to 1.20, 817 events, 2879 participants, 2 trials) or stroke (RR 1.36, 95% CI 0.45 to 4.11, 54 events, 3730 participants, 4 trials), as we assessed the evidence as being of very low quality. We found no evidence of dose-response or duration effects for any primary outcome, but there was a suggestion of greater protection in participants with lower baseline omega-6 intake across outcomes.Additional key outcomes: we found increased intake of omega-6 fats may reduce myocardial infarction (MI) risk (RR 0.88, 95% CI 0.76 to 1.02, 609 events, 4606 participants, 7 trials, low-quality evidence). High-quality evidence suggests increasing omega-6 fats reduces total serum cholesterol a little in the long term (mean difference (MD) -0.33 mmol/L, 95% CI -0.50 to -0.16, I2 = 81%; heterogeneity partially explained by dose, 4280 participants, 10 trials). Increasing omega-6 fats probably has little or no effect on adiposity (body mass index (BMI) MD -0.20 kg/m2, 95% CI -0.56 to 0.16, 371 participants, 1 trial, moderate-quality evidence). It may make little or no difference to serum triglycerides (MD -0.01 mmol/L, 95% CI -0.23 to 0.21, 834 participants, 5 trials), HDL (MD -0.01 mmol/L, 95% CI -0.03 to 0.02, 1995 participants, 4 trials) or low-density lipoprotein (MD -0.04 mmol/L, 95% CI -0.21 to 0.14, 244 participants, 2 trials, low-quality evidence).

AUTHORS' CONCLUSIONS:

This is the most extensive systematic assessment of effects of omega-6 fats on cardiovascular health, mortality, lipids and adiposity to date, using previously unpublished data. We found no evidence that increasing omega-6 fats reduces cardiovascular outcomes other than MI, where 53 people may need to increase omega-6 fat intake to prevent 1 person from experiencing MI. Although benefits of omega-6 fats remain to be proven, increasing omega-6 fats may be of benefit in people at high risk of MI. Increased omega-6 fats reduce serum total cholesterol but not other blood fat fractions or adiposity.

 

Canadians' average life expectancy could be cut by opioid scourge

Canada to start factoring opioid-related overdoses into average life expectancies

Catharine Tunney · CBC News · Posted: Jul 18, 2018

http://www.cbc.ca/news/politics/life-expectancy-opioids-canada-1.4748671

 

Protein Biomarkers of Cardiovascular Disease and Mortality in the Community.

Ho JE, Lyass A, Courchesne P, Chen G, Liu C, Yin X, Hwang SJ, Massaro JM, Larson MG, Levy D.

J Am Heart Assoc. 2018 Jul 13;7(14). pii: e008108. doi: 10.1161/JAHA.117.008108.

PMID: 30006491 Free Article

http://jaha.ahajournals.org/content/7/14/e008108

Abstract

BACKGROUND:

The discovery of novel and highly predictive biomarkers of cardiovascular disease (CVD) has the potential to improve risk-stratification methods and may be informative regarding biological pathways contributing to disease.

METHODS AND RESULTS:

We used a discovery proteomic platform that targeted high-value proteins for CVD to ascertain 85 circulating protein biomarkers in 3523 Framingham Heart Study participants (mean age, 62 years; 53% women). Using multivariable-adjusted Cox models to account for clinical variables, we found 8 biomarkers associated with incident atherosclerotic CVD, 18 with incident heart failure, 38 with all-cause mortality, and 35 with CVD death (false discovery rate, q<0.05 for all; P-value ranges, 9.8×10-34 to 3.6×10-2). Notably, a number of regulators of metabolic and adipocyte homeostasis were associated with cardiovascular events, including insulin-like growth factor 1 (IGF1), insulin-like growth factor binding protein 1 (IGFBP1), insulin-like growth factor binding protein 2 (IGFBP2), leptin, and adipsin. In a multimarker approach that accounted for clinical factors, growth differentiation factor 15 (GDF15) was associated with all outcomes. In addition, N-terminal pro-b-type natriuretic peptide, C-reactive protein, and leptin were associated with incident heart failure, and C-type lectin domain family 3 member B (CLEC3B; tetranectin), N-terminal pro-b-type natriuretic peptide, arabinogalactan protein 1 (AGP1), soluble receptor for advanced glycation end products (sRAGE), peripheral myelin protein 2 (PMP2), uncarboxylated matrix Gla protein (UCMGP), kallikrein B1 (KLKB1), IGFBP2, IGF1, leptin receptor, and cystatin-C were associated with all-cause mortality in a multimarker model.

CONCLUSIONS:

We identified numerous protein biomarkers that predicted cardiovascular outcomes and all-cause mortality, including biomarkers representing regulators of metabolic homeostasis and inflammatory pathways. Further studies are needed to validate our findings and define clinical utility, with the ultimate goal of improving strategies for CVD prevention.

KEYWORDS:

cardiovascular disease risk factors; epidemiology; proteomics

 

Cannabinoids, the Heart of the Matter.

Alfulaij N, Meiners F, Michalek J, Small-Howard AL, Turner HC, Stokes AJ.

J Am Heart Assoc. 2018 Jul 13;7(14). pii: e009099. doi: 10.1161/JAHA.118.009099. Review. No abstract available.

PMID: 30006489 Free Article

http://jaha.ahajournals.org/content/7/14/e009099?etoc

"Endocannabinoids and cannabinoid‐related compounds may be a promising approach as therapeutic agents for cardiovascular diseases. However, there are several challenges that arise when considering these targets."

 

Omega-6 fats for the primary and secondary prevention of cardiovascular disease.

Hooper L, Al-Khudairy L, Abdelhamid AS, Rees K, Brainard JS, Brown TJ, Ajabnoor SM, O'Brien AT, Winstanley LE, Donaldson DH, Song F, Deane KH.

Cochrane Database Syst Rev. 2018 Jul 18;7:CD011094. doi: 10.1002/14651858.CD011094.pub3. [Epub ahead of print] Review.

PMID: 30019765

Abstract

BACKGROUND:

Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovascular disease (CVD) risk is debated.

OBJECTIVES:

To assess effects of increasing omega-6 fats (linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA)) on CVD and all-cause mortality.

SEARCH METHODS:

We searched CENTRAL, MEDLINE and Embase to May 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA:

We included randomised controlled trials (RCTs) comparing higher versus lower omega-6 fat intake in adults with or without CVD, assessing effects over at least 12 months. We included full texts, abstracts, trials registry entries and unpublished studies. Outcomes were all-cause mortality, CVD mortality, CVD events, risk factors (blood lipids, adiposity, blood pressure), and potential adverse events. We excluded trials where we could not separate omega-6 fat effects from those of other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS:

Two authors independently screened titles/abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias of included trials. We wrote to authors of included studies. Meta-analyses used random-effects analysis, while sensitivity analyses used fixed-effects and limited analyses to trials at low summary risk of bias. We assessed GRADE quality of evidence for 'Summary of findings' tables.

MAIN RESULTS:

We included 19 RCTs in 6461 participants who were followed for one to eight years. Seven trials assessed the effects of supplemental GLA and 12 of LA, none DGLA or AA; the omega-6 fats usually displaced dietary saturated or monounsaturated fats. We assessed three RCTs as being at low summary risk of bias.Primary outcomes: we found low-quality evidence that increased intake of omega-6 fats may make little or no difference to all-cause mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.88 to 1.12, 740 deaths, 4506 randomised, 10 trials) or CVD events (RR 0.97, 95% CI 0.81 to 1.15, 1404 people experienced events of 4962 randomised, 7 trials). We are uncertain whether increasing omega-6 fats affects CVD mortality (RR 1.09, 95% CI 0.76 to 1.55, 472 deaths, 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997 randomised, 7 trials), major adverse cardiac and cerebrovascular events (RR 0.84, 95% CI 0.59 to 1.20, 817 events, 2879 participants, 2 trials) or stroke (RR 1.36, 95% CI 0.45 to 4.11, 54 events, 3730 participants, 4 trials), as we assessed the evidence as being of very low quality. We found no evidence of dose-response or duration effects for any primary outcome, but there was a suggestion of greater protection in participants with lower baseline omega-6 intake across outcomes.Additional key outcomes: we found increased intake of omega-6 fats may reduce myocardial infarction (MI) risk (RR 0.88, 95% CI 0.76 to 1.02, 609 events, 4606 participants, 7 trials, low-quality evidence). High-quality evidence suggests increasing omega-6 fats reduces total serum cholesterol a little in the long term (mean difference (MD) -0.33 mmol/L, 95% CI -0.50 to -0.16, I2 = 81%; heterogeneity partially explained by dose, 4280 participants, 10 trials). Increasing omega-6 fats probably has little or no effect on adiposity (body mass index (BMI) MD -0.20 kg/m2, 95% CI -0.56 to 0.16, 371 participants, 1 trial, moderate-quality evidence). It may make little or no difference to serum triglycerides (MD -0.01 mmol/L, 95% CI -0.23 to 0.21, 834 participants, 5 trials), HDL (MD -0.01 mmol/L, 95% CI -0.03 to 0.02, 1995 participants, 4 trials) or low-density lipoprotein (MD -0.04 mmol/L, 95% CI -0.21 to 0.14, 244 participants, 2 trials, low-quality evidence).

AUTHORS' CONCLUSIONS:

This is the most extensive systematic assessment of effects of omega-6 fats on cardiovascular health, mortality, lipids and adiposity to date, using previously unpublished data. We found no evidence that increasing omega-6 fats reduces cardiovascular outcomes other than MI, where 53 people may need to increase omega-6 fat intake to prevent 1 person from experiencing MI. Although benefits of omega-6 fats remain to be proven, increasing omega-6 fats may be of benefit in people at high risk of MI. Increased omega-6 fats reduce serum total cholesterol but not other blood fat fractions or adiposity.

 

Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.

Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, AlAbdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L.

Cochrane Database Syst Rev. 2018 Jul 18;7:CD003177. doi: 10.1002/14651858.CD003177.pub3. [Epub ahead of print] Review.

PMID: 30019766

Abstract

BACKGROUND:

Researchers have suggested that omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this.

OBJECTIVES:

To assess effects of increased intake of fish- and plant-based omega-3 for all-cause mortality, cardiovascular (CVD) events, adiposity and lipids.

SEARCH METHODS:

We searched CENTRAL, MEDLINE and Embase to April 2017, plus ClinicalTrials.gov and World Health Organization International Clinical Trials Registry to September 2016, with no language restrictions. We handsearched systematic review references and bibliographies and contacted authors.

SELECTION CRITERIA:

We included randomised controlled trials (RCTs) that lasted at least 12 months and compared supplementation and/or advice to increase LCn3 or ALA intake versus usual or lower intake.

DATA COLLECTION AND ANALYSIS:

Two review authors independently assessed studies for inclusion, extracted data and assessed validity. We performed separate random-effects meta-analysis for ALA and LCn3 interventions, and assessed dose-response relationships through meta-regression.

MAIN RESULTS:

We included 79 RCTs (112,059 participants) in this review update and found that 25 were at low summary risk of bias. Trials were of 12 to 72 months' duration and included adults at varying cardiovascular risk, mainly in high-income countries. Most studies assessed LCn3 supplementation with capsules, but some used LCn3- or ALA-rich or enriched foods or dietary advice compared to placebo or usual diet.Meta-analysis and sensitivity analyses suggested little or no effect of increasing LCn3 on all-cause mortality (RR 0.98, 95% CI 0.90 to 1.03, 92,653 participants; 8189 deaths in 39 trials, high-quality evidence), cardiovascular mortality (RR 0.95, 95% CI 0.87 to 1.03, 67,772 participants; 4544 CVD deaths in 25 RCTs), cardiovascular events (RR 0.99, 95% CI 0.94 to 1.04, 90,378 participants; 14,737 people experienced events in 38 trials, high-quality evidence), coronary heart disease (CHD) mortality (RR 0.93, 95% CI 0.79 to 1.09, 73,491 participants; 1596 CHD deaths in 21 RCTs), stroke (RR 1.06, 95% CI 0.96 to 1.16, 89,358 participants; 1822 strokes in 28 trials) or arrhythmia (RR 0.97, 95% CI 0.90 to 1.05, 53,796 participants; 3788 people experienced arrhythmia in 28 RCTs). There was a suggestion that LCn3 reduced CHD events (RR 0.93, 95% CI 0.88 to 0.97, 84,301 participants; 5469 people experienced CHD events in 28 RCTs); however, this was not maintained in sensitivity analyses - LCn3 probably makes little or no difference to CHD event risk. All evidence was of moderate GRADE quality, except as noted.Increasing ALA intake probably makes little or no difference to all-cause mortality (RR 1.01, 95% CI 0.84 to 1.20, 19,327 participants; 459 deaths, 5 RCTs),cardiovascular mortality (RR 0.96, 95% CI 0.74 to 1.25, 18,619 participants; 219 cardiovascular deaths, 4 RCTs), and it may make little or no difference to CHD events (RR 1.00, 95% CI 0.80 to 1.22, 19,061 participants, 397 CHD events, 4 RCTs, low-quality evidence). However, increased ALA may slightly reduce risk of cardiovascular events (from 4.8% to 4.7%, RR 0.95, 95% CI 0.83 to 1.07, 19,327 participants; 884 CVD events, 5 RCTs, low-quality evidence), and probably reduces risk of CHD mortality (1.1% to 1.0%, RR 0.95, 95% CI 0.72 to 1.26, 18,353 participants; 193 CHD deaths, 3 RCTs), and arrhythmia (3.3% to 2.6%, RR 0.79, 95% CI 0.57 to 1.10, 4,837 participants; 141 events, 1 RCT). Effects on stroke are unclear.Sensitivity analysis retaining only trials at low summary risk of bias moved effect sizes towards the null (RR 1.0) for all LCn3 primary outcomes except arrhythmias, but for most ALA outcomes, effect sizes moved to suggest protection. LCn3 funnel plots suggested that adding in missing studies/results would move effect sizes towards null for most primary outcomes. There were no dose or duration effects in subgrouping or meta-regression.There was no evidence that increasing LCn3 or ALA altered serious adverse events, adiposity or lipids, although LCn3 slightly reduced triglycerides and increased HDL. ALA probably reduces HDL (high- or moderate-quality evidence).

AUTHORS' CONCLUSIONS:

This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and high-quality evidence suggests that increasing EPA and DHA has little or no effect on mortality or cardiovascular health (evidence mainly from supplement trials). Previous suggestions of benefits from EPA and DHA supplements appear to spring from trials with higher risk of bias. Low-quality evidence suggests ALA may slightly reduce CVD event risk, CHD mortality and arrhythmia.

 

Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease.

Abdelhamid AS, Martin N, Bridges C, Brainard JS, Wang X, Brown TJ, Hanson S, Jimoh OF, Ajabnoor SM, Deane KH, Song F, Hooper L.

Cochrane Database Syst Rev. 2018 Jul 18;7:CD012345. doi: 10.1002/14651858.CD012345.pub2. [Epub ahead of print] Review.

PMID: 30019767

Abstract

BACKGROUND:

Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests that increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear.

OBJECTIVES:

To assess effects of increasing total PUFA intake on cardiovascular disease and all-cause mortality, lipids and adiposity in adults.

SEARCH METHODS:

We searched CENTRAL, MEDLINE and Embase to April 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA:

We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults with or without cardiovascular disease that assessed effects over 12 months or longer. We included full texts, abstracts, trials registry entries and unpublished data. Outcomes were all-cause mortality, cardiovascular disease mortality and events, risk factors (blood lipids, adiposity, blood pressure), and adverse events. We excluded trials where we could not separate effects of PUFA intake from other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS:

Two review authors independently screened titles and abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias. We wrote to authors of included trials for further data. Meta-analyses used random-effects analysis, sensitivity analyses included fixed-effects and limiting to low summary risk of bias. We assessed GRADE quality of evidence.

MAIN RESULTS:

We included 49 RCTs randomising 24,272 participants, with duration of one to eight years. Eleven included trials were at low summary risk of bias, 33 recruited participants without cardiovascular disease. Baseline PUFA intake was unclear in most trials, but 3.9% to 8% of total energy intake where reported. Most trials gave supplemental capsules, but eight gave dietary advice, eight gave supplemental foods such as nuts or margarine, and three used a combination of methods to increase PUFA.Increasing PUFA intake probably has little or no effect on all-cause mortality (risk 7.8% vs 7.6%, risk ratio (RR) 0.98, 95% confidence interval (CI) 0.89 to 1.07, 19,290 participants in 24 trials), but probably slightly reduces risk of coronary heart disease events from 14.2% to 12.3% (RR 0.87, 95% CI 0.72 to 1.06, 15 trials, 10,076 participants) and cardiovascular disease events from 14.6% to 13.0% (RR 0.89, 95% CI 0.79 to 1.01, 17,799 participants in 21 trials), all moderate-quality evidence. Increasing PUFA may slightly reduce risk of coronary heart disease death (6.6% to 6.1%, RR 0.91, 95% CI 0.78 to 1.06, 9 trials, 8810 participants) andstroke (1.2% to 1.1%, RR 0.91, 95% CI 0.58 to 1.44, 11 trials, 14,742 participants, though confidence intervals include important harms), but has little or no effect on cardiovascular mortality (RR 1.02, 95% CI 0.82 to 1.26, 16 trials, 15,107 participants) all low-quality evidence. Effects of increasing PUFA on major adverse cardiac and cerebrovascular events and atrial fibrillation are unclear as evidence is of very low quality.Increasing PUFA intake slightly reduces total cholesterol (mean difference (MD) -0.12 mmol/L, 95% CI -0.23 to -0.02, 26 trials, 8072 participants) and probably slightly decreases triglycerides (MD -0.12 mmol/L, 95% CI -0.20 to -0.04, 20 trials, 3905 participants), but has little or no effect on high-density lipoprotein (HDL) (MD -0.01 mmol/L, 95% CI -0.02 to 0.01, 18 trials, 4674 participants) or low-density lipoprotein (LDL) (MD -0.01 mmol/L, 95% CI -0.09 to 0.06, 15 trials, 3362 participants). Increasing PUFA probably causes slight weight gain (MD 0.76 kg, 95% CI 0.34 to 1.19, 12 trials, 7100 participants).Effects of increasing PUFA on serious adverse events such as pulmonary embolism and bleeding are unclear as the evidence is of very low quality.

AUTHORS' CONCLUSIONS:

This is the most extensive systematic review of RCTs conducted to date to assess effects of increasing PUFA on cardiovascular disease, mortality, lipids or adiposity. Increasing PUFA intake probably slightly reduces risk of coronary heart disease and cardiovascular disease events, may slightly reduce risk of coronary heart disease mortality and stroke (though not ruling out harms), but has little or no effect on all-cause or cardiovascular disease mortality. The mechanism may be via lipid reduction, but increasing PUFA probably slightly increases weight.

 

Impact of Edible Cricket Consumption on Gut Microbiota in Healthy Adults, a Double-blind, Randomized Crossover Trial.

Stull VJ, Finer E, Bergmans RS, Febvre HP, Longhurst C, Manter DK, Patz JA, Weir TL.

Sci Rep. 2018 Jul 17;8(1):10762. doi: 10.1038/s41598-018-29032-2.

PMID: 30018370

https://www.nature.com/articles/s41598-018-29032-2.pdf

Abstract

Edible insects are often considered a nutritious, protein-rich, environmentally sustainable alternative to traditional livestock with growing popularity among North American consumers. While the nutrient composition of several insects is characterized, all potential health impacts have not been evaluated. In addition to high protein levels, crickets contain chitin and other fibers that may influence gut health. In this study, we evaluated the effects of consuming 25 grams/day whole cricket powder on gut microbiota composition, while assessing safety and tolerability. Twenty healthy adults participated in this six-week, double-blind, crossover dietary intervention. Participants were randomized into two study arms and consumed either cricket-containing or control breakfast foods for 14 days, followed by a washout period and assignment to the opposite treatment. Blood and stool samples were collected at baseline and after each treatment period to assess liver function and microbiota changes. Results demonstrate cricket consumption is tolerable and non-toxic at the studied dose. Cricket powder supported growth of the probiotic bacterium, Bifidobacterium animalis, which increased 5.7-fold. Cricket consumption was also associated with reduced plasma TNF-α. These data suggest that eating crickets may improve gut health and reduce systemic inflammation; however, more research is needed to understand these effects and underlying mechanisms.

 

Dietary Sodium to Potassium Ratio and the Incidence of Chronic Kidney Disease in Adults: A Longitudinal Follow-Up Study.

Mirmiran P, Nazeri P, Bahadoran Z, Khalili-Moghadam S, Azizi F.

Prev Nutr Food Sci. 2018 Jun;23(2):87-93. doi: 10.3746/pnf.2018.23.2.87. Epub 2018 Jun 30.

PMID: 30018885

Abstract

The aim of this study was to explore the association of dietary sodium to potassium (Na/K) ratio and the risk of chronic kidney disease (CKD) in general Iranian adults. In this prospective cohort study, 1,780 adults, free of baseline CKD with complete follow-up data, were selected from among participants of the Tehran Lipid and Glucose Study and followed for 6.3 years for development of CKD. Dietary sodium and potassium were assessed using a valid and reliable 168-item food frequency questionnaire. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease Study equation, and CKD was defined as eGFR <60 mL/min/1.73 m2. Mean dietary intakes of sodium and potassium were 4,547±3,703 and 3,753±1,485 mg/d, respectively, and their ratio was 1.35±1.29. No significant association was found between dietary intakes of sodium and potassium and the risk of CKD after 6.3 y of follow-up, whereas in the case of dietary Na/K ratio, participants in the highest compared to lowest tertile (2.43 vs 1.61) had a significantly increased risk of CKD (odds ratio=1.52, 95% confidence interval=1.01~2.30); an increasing trend in the risk of CKD across tertiles of dietary sodium to potassium ratio was also observed (P for trend=0.05). Present findings demonstrate that the dietary Na/K ratio is a stronger predictor of CKD than the dietary sodium or potassium per se. Decreased dietary Na/K ratio may be considered as an effective dietary approach to modify the risk of kidney dysfunction.

KEYWORDS:

chronic kidney disease; dietary potassium; dietary sodium; sodium to potassium ratio

 

Association of fish and long-chain omega-3 fatty acids intakes with total and cause-specific mortality: prospective analysis of 421 309 individuals.

Zhang Y, Zhuang P, He W, Chen JN, Wang WQ, Freedman ND, Abnet CC, Wang JB, Jiao JJ.

J Intern Med. 2018 Jul 17. doi: 10.1111/joim.12786. [Epub ahead of print]

PMID: 30019399

Abstract

BACKGROUND:

Prevailing dietary guidelines recommend regular fish consumption. However, the associations of fish and long-chain omega-3 polyunsaturated fatty acids (LCn-3 PUFAs) intakes with mortality remain unclear.

OBJECTIVES:

To examine the associations of fish and LCn-3 PUFAs intakes with total and cause-specific mortality.

METHODS:

A total of 240 729 men and 180 580 women from NIH-AARP Diet and Health Study were prospectively followed-up for 16 years. Dietary intakes were assessed using a validated NIH Diet History Questionnaire.

RESULTS:

A total of 54 230 men and 30 882 women died during 6.07 million person-years of follow-up. Higher fish and LCn-3 PUFAs intakes were significantly associated with lower total mortality (P < 0.0001). Comparing the highest with lowest quintiles of fish intake, men had 9% (95% confidence interval, 6-11%) lower total mortality, 10% (6-15%) lower cardiovascular disease (CVD) mortality, 6% (1-10%) lower cancer mortality, 20% (11-28%) lower respiratory disease mortality and 37% (17-53%) lower chronic liver disease mortality, while women had 8% (5-12%) lower total mortality, 10% (3-17%) lower CVD mortality and 38% (20-52%) lower Alzheimer's disease mortality. Fried fish consumption was not related to mortality in men whereas positively associated with mortality from all causes (P = 0.011), CVD and respiratory disease in women. LCn-3 PUFAs intake was associated with 15% and 18% lower CVD mortality in men and women across extreme quintiles, respectively.

CONCLUSION:

Consumption of fish and LCn-3 PUFAs was robustly associated with lower mortality from major causes. Our findings support current guidelines for fish consumption while advice on non-frying preparation methods is needed.

KEYWORDS:

AARP diet and health study; cardiovascular disease; long-chain omega-3 fatty acids; marine fish; mortality

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Long-Term Effects of Dietary Protein and Branched-Chain Amino Acids on Metabolism and Inflammation in Mice.

Mu WC, VanHoosier E, Elks CM, Grant RW.

Nutrients. 2018 Jul 18;10(7). pii: E918. doi: 10.3390/nu10070918.

PMID: 30021962

http://www.mdpi.com/2072-6643/10/7/918/htm

Abstract

Aging is the main factor involved in the onset of degenerative diseases. Dietary protein restriction has been shown to increase the lifespan of rodents and improve metabolic phenotype. Branched-chain amino acids (BCAA) can act as nutrient signals that increase the lifespan of mice after prolonged supplementation. It remains unclear whether the combination of protein restriction and BCAA supplementation improves metabolic and immunological profiles during aging. Here, we investigated how dietary protein levels and BCAA supplementation impact metabolism and immune profile during a 12-month intervention in adult male C57BL/6J mice. We found that protein restriction improved insulin tolerance and increased hepatic fibroblast growth factor 21 mRNA, circulating interleukin (IL)-5 concentration, and thermogenic uncoupling protein 1 in subcutaneous white fat. Surprisingly, BCAA supplementation conditionally increased body weight, lean mass, and fat mass, and deteriorated insulin intolerance during protein restriction, but not during protein sufficiency. BCAA also induced pro-inflammatory gene expression in visceral adipose tissue under both normal and low protein conditions. These results suggest that dietary protein levels and BCAA supplementation coordinate a complex regulation of metabolism and tissue inflammation during prolonged feeding.

KEYWORDS:

body composition; branched-chain amino acids; glucose homeostasis; inflammation; low protein diet

 

Limiting feeding to the active phase reduces blood pressure without the necessity of caloric reduction or fat mass loss.

Cote I, Toklu HZ, Green SM, Morgan D, Carter CS, Tumer N, Scarpace PJ.

Am J Physiol Regul Integr Comp Physiol. 2018 Jul 19. doi: 10.1152/ajpregu.00076.2018. [Epub ahead of print]

PMID: 30024775

Abstract

Reducing body weight has been shown to lower blood pressure in obesity-related hypertension. However, success of those lifestyle interventions is limited due to poor long-term compliance. Emerging evidence indicate that feeding schedule plays a role on the regulation of blood pressure. With two studies, we examined the role of feeding schedule on energy homeostasis and blood pressure. In Study 1, rats were fed a high fat diet (HFD) ad libitum for 24 hours (Control) or for 12 hours during the dark phase (time-restricted feeding; TRF). In Study 2, rats fed a HFD were administered a long acting a-MSH analog at either light onset (MTII light) or dark onset (MTII dark) or saline (Control). MTII light animals ate most of their calories during the active phase, similar to the TRF group. In Study 1, Control and TRF rats consumed the same amount of food and gained the same amount of weight and fat mass. Interestingly, systolic and mean arterial pressure (MAP) was lower in TRF group. In Study 2, food intake was significantly lower in both MTII groups relative to Control. Although timing of injection affected light vs dark phase food consumption, neither body weight nor fat mass differed between MTII groups. Consistent with Study 1, rats consuming their calories during the active phase displayed lower MAP. These data indicate that limiting feeding to the active phase reduces blood pressure without the necessity of reducing calories or fat mass, which could be relevant to obesity-related hypertension.

KEYWORDS:

Melanotan II; blood pressure; body weight; energy homeostasis; feeding schedule

 

A Controlled Increase in Dietary Phosphate Elevates BP in Healthy Human Subjects.

Mohammad J, Scanni R, Bestmann L, Hulter HN, Krapf R.

J Am Soc Nephrol. 2018 Jul 18. pii: ASN.2017121254. doi: 10.1681/ASN.2017121254. [Epub ahead of print]

PMID: 30021759

Abstract

Background Despite epidemiologic evidence for increased cardiovascular morbidity and mortality associated with both high dietary and serum phosphate in humans with normal renal function, no controlled phosphate intervention studies of systemic hemodynamics have been reported. Higher serum 25(OH) vitamin D levels are associated with better cardiovascular outcomes, but vitamin D increases intestinal phosphate absorption.Methods We conducted a prospective outpatient study with blinded assessment in 20 young adults with normal renal function randomized to high phosphate (regular diet plus 1 mmol/kg body wt per day of Na as neutral sodium phosphate) or low phosphate (regular diet plus lanthanum, 750 mg thrice/day, plus 0.7 mmol/kg body wt per day of Na as NaCl) for 11 weeks. After 6 weeks, all subjects received vitamin D3 (600,000 U) by intramuscular injection. Outcome parameters were 24-hour ambulatory systolic and diastolic BP (SBP and DBP), pulse rate (PR), biomarkers, and measures of endothelial and arterial function.Results Compared with the low-phosphate diet group, the high-phosphate diet group had a significant increase in mean±SEM fasting plasma phosphate concentration (0.23±0.11 mmol/L); 24-hour SBP and DBP (+4.1; 95% confidence interval [95% CI], 2.1 to 6.1; and +3.2; 95% CI, 1.2 to 5.2 mm Hg, respectively); mean 24-hour PR (+4.0; 95% CI, 2.0 to 6.0 beats/min); and urinary metanephrine and normetanephrine excretion (54; 95% CI, 50 to 70; and 122; 95% CI, 85 to 159 µg/24 hr, respectively). Vitamin D had no effect on any of these parameters. Neither high- nor low-phosphate diet nor vitamin D affected endothelial function or arterial elasticity.Conclusions Increased phosphate intake (controlled for sodium) significantly increases SBP, DBP, and PR in humans with normal renal function, in part, by increasing sympathoadrenergic activity.

KEYWORDS:

FGF-23; Vitamin D; hyperphosphatemia; hypertension; phosphate

 

The Influence of Sodium and Potassium Intake and Insulin Resistance on Blood Pressure in Normotensive Individuals Is More Evident in Women.

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

Am J Hypertens. 2018 Jul 16;31(8):876-885. doi: 10.1093/ajh/hpy041.

PMID: 29547880

Abstract

BACKGROUND:

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

METHODS:

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

RESULTS:

Multivariate regression analysis revealed that a 10-mmol/day increment in urinary sodium excretion related to an elevation in systolic blood pressure of 0.16 mm Hg in men and 0.37 mm Hg in women, after adjusting for known risk factors to salt sensitivity, including age, body mass index, serum creatinine, homeostasis model assessment of IR, and urinary potassium excretion. For urinary potassium excretion, a 10-mmol/day increment was associated with a decrease in systolic blood pressure, -0.54 mm Hg in men and -1.49 mm Hg in women, respectively. Furthermore, involvement of IR on blood pressure was observed only in women.

CONCLUSIONS:

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

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Potato consumption is prospectively associated with risk of hypertension: An 11.3-year longitudinal cohort study.

Huang M, Zhuang P, Jiao J, Wang J, Chen X, Zhang Y.

Clin Nutr. 2018 Jul 2. pii: S0261-5614(18)31192-0. doi: 10.1016/j.clnu.2018.06.973. [Epub ahead of print]

PMID: 30025746

Abstract

BACKGROUND & AIMS:

Government has popularized potatoes as the staple food in China. Potatoes as a potassium-rich food show high glycemic responses after consumption. Whether potato consumption is prospectively linked with the risk of hypertension remains unclear in oriental populations. In this study, we aimed to investigate the association of potato consumption with the risk of hypertension among Chinese people.

METHODS:

A total of 11,763 adults (≥20 years old) who were free of hypertension at baseline were enrolled from China Health and Nutrition Survey (CHNS) Cohort study in 1989-2011. Participants were excluded if they were <20 years old, identified to be pregnant, and previously diagnosed with hypertension, cancers, infarction, apoplexy and diabetes at baseline. Cox proportional hazards regression models were used to estimate the associations after adjusting for potential confounders.

RESULTS:

During average 11.3 years of follow-up, 4033 incident cases of hypertension were ascertained. People who consumed more amounts of total potatoes, stir-fried potatoes, and non stir-fried potatoes had higher risk of hypertension (P for trend = 0.1225, 0.2168 and 0.0456, respectively). Multivariable hazard ratios (HRs) for increased consumption of total potatoes were 1.402 (95% confidence interval [CI], 1.270-1.548), 1.198 (95% CI, 1.014-1.415), and 1.120 (95% CI, 0.929-1.349) compared with non-consumers. However, the participants with higher intake of potato consumption were inclined to have lower risk of hypertension when excluding the non-consumers of total potatoes or stir-fried potatoes (P for trend = 0.0271 and 0.0001). In addition, a positive association of sweet potatoes intake with hypertension risk was only found in urban residents (P for trend = 0.0239).

CONCLUSIONS:

Our results showed that potato consumption was prospectively associated with hypertension in Chinese population. As the urbanization process continues along with the transition to Western-style diets, more consideration should be taken before the formulation of potato popularization is promoted in China.

KEYWORDS:

China Health and Nutrition Survey; Hypertension; Potato consumption; Stir-fried potatoes; Sweet potatoes

 

Integrated Remodeling of Gut-Liver Metabolism Induced by Moderate Protein Restriction Contributes to Improvement of Insulin Sensitivity.

Zhang X, Qiu K, Wang L, Xu D, Yin J.

Mol Nutr Food Res. 2018 Jul 21:e1800637. doi: 10.1002/mnfr.201800637. [Epub ahead of print]

PMID: 30030886

Abstract

SCOPE:

Protein restriction (PR) is beneficial to relieving metabolic disorders and ageing related diseases. However, extreme PR could result in malnutrition due to severe deficiency of essential amino acids. Therefore, in this study, we investigated the effect of moderate PR on insulin sensitivity.

METHODS AND RESULTS:

The growing and adult pigs were subjected to moderate PR by 15%∼30%. Plasma insulin concentration and insulin resistance index HOMA-IR were significantly decreased upon moderate PR. Furthermore, IRS1/PI3K/AKT pathway in basal state was enhanced in both liver and skeletal muscle. The adapted metabolism in the liver upon moderate PR was in support of improving insulin sensitivity. The liver shared a coordinated metabolic adaption in terms of energy metabolism and amino acid metabolism with the small intestine. Particularly, alteration of metabolic footprint appeared in the portal venous blood, representing metabolites to be absorbed into liver after intestinal metabolism, was also in favor of improvement of insulin sensitivity.

CONCLUSION:

In summary, our study proved that moderate PR could improve insulin sensitivity from childhood to adulthood in a pig model, and shed a new light on the role of integrated remodeling of gut and liver metabolism in the improved insulin sensitivity induced by moderate PR. This article is protected by copyright. All rights reserved.

KEYWORDS:

Gut-liver metabolism; Insulin sensitivity; Moderate protein restriction; Pig model

 

Effect of twice-weekly calorie restriction diet for glycemic control in patients with type 2 diabetes

EurekAlert (press release)

https://www.eurekalert.org/pub_releases/2018-07/jn-eot071718.php

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

Effect of Intermittent Compared With Continuous Energy Restricted Diet on Glycemic Control in Patients With Type 2 DiabetesA Randomized Noninferiority Trial

Sharayah Carter, BND; Peter M. Clifton, MD, PhD; Jennifer B. Keogh, PhD

This randomized noninferiority trial compares the effects of intermittent (2 days per week) energy restricted diet with those of continuous energy restricted diet on glycemic control and weight loss in adults with type 2 diabetes during a 12-month period.

JAMA Network Open. 2018;1(3):e180756. doi:10.1001/jamanetworkopen.2018.0756

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2688344

Key Points

Question Is intermittent energy restriction comparable to continuous energy restriction for glycemic control in patients with type 2 diabetes?

Findings In this randomized noninferiority trial, the mean change in hemoglobin A1c level after 12 months in the intermittent energy restriction group (–0.3%) was comparable to that of the continuous energy restriction group (–0.5%), reaching the criterion for equivalence in intention-to-treat and completers analysis.

Meaning Intermittent energy restriction is comparable to continuous energy restriction for glycemic control in patients with type 2 diabetes.

Abstract

Importance Intermittent energy restriction is an alternative weight loss method that is becoming popular; however, to date, there are no long-term clinical trials of intermittent energy restriction in patients with type 2 diabetes.

Objective To compare the effects of intermittent energy restriction (2 days per week) with those of continuous energy restriction on glycemic control and weight loss in patients with type 2 diabetes during a 12-month period.

Design, Setting, and Participants Adult participants (N = 137) with type 2 diabetes were randomized 1:1 to parallel diet groups (intermittent energy restriction [n = 70] or continuous energy restriction [n = 67]) between April 7, 2015, and September 7, 2017, at the University of South Australia. Medications likely to cause hypoglycemia were reduced at baseline according to the medication management protocol.

Interventions An intermittent energy restriction diet (500-600 kcal/d) followed for 2 nonconsecutive days per week (participants followed their usual diet for the other 5 days) or a continuous energy restriction diet (1200-1500 kcal/d) followed for 7 days per week for 12 months.

Main Outcomes and Measures The primary outcome was change in hemoglobin A1c (HbA1c) level, with equivalence prespecified by a 90% CI margin of ±0.5%. The secondary outcome was weight loss with equivalence set at ±2.5 kg (±1.75 kg for fat mass loss and ±0.75 kg for fat-free mass loss). All other outcomes were tested for superiority.

Results Of the 137 randomized participants (77 women and 60 men; mean [sD] age, 61.0 [9.1] years; mean [sD] body mass index, 36.0 [5.8] [calculated as weight in kilograms divided by height in meters squared]; and mean [sD] HbA1c level, 7.3% [1.3%]), 97 completed the trial. Intention-to-treat analysis showed similar reductions in mean (SEM) HbA1c level between the continuous and intermittent energy restriction groups (–0.5% [0.2%] vs –0.3% [0.1%]; P = .65), with a between-group difference of 0.2% (90% CI, –0.2% to 0.5%) meeting the criteria for equivalence. Mean (SEM) weight change was similar between the continuous and intermittent energy restriction groups (–5.0 [0.8] kg vs –6.8 [0.8] kg; P = .25), but the between-group difference did not meet the criteria for equivalence (–1.8 kg; 90% CI, –3.7 to 0.07 kg), nor did the between-group difference in fat mass (–1.3 kg; 90% CI, –2.8 to 0.2 kg) or fat-free mass (–0.5 kg; 90% CI, –1.4 to 0.4 kg). There were no significant differences between groups in final step count, fasting glucose levels, lipid levels, or total medication effect score at 12 months. Effects did not differ using completers analysis. Hypoglycemic or hyperglycemic events in the first 2 weeks of treatment were similar between the continuous and intermittent energy restriction groups (mean number [sEM] of events, 3.2 [0.7] vs 4.9 [1.4]; P = .28), affecting 35% of participants (16 of 46) using sulfonylureas and/or insulin.

Conclusions and Relevance Intermittent energy restriction is an effective alternative diet strategy for the reduction of HbA1c and is comparable with continuous energy restriction in patients with type 2 diabetes.

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Dietary oleic acid is inversely associated with pancreatic cancer - Data from food diaries in a cohort study.

Banim PJ, Luben R, Khaw KT, Hart AR.

Pancreatology. 2018 Jul 10. pii: S1424-3903(18)30631-8. doi: 10.1016/j.pan.2018.07.004. [Epub ahead of print]

PMID: 30031691

https://sci-hub.tw/https://linkinghub.elsevier.com/retrieve/pii/S1424390318306318

Abstract

BACKGROUND:

Dietary oleic acid may prevent pancreatic ductal adenocarcinoma (PDA) by reducing hyperinsulinaemia which can otherwise promote DNA damage and tumour growth. Results from previous epidemiological studies investigating oleic acid are inconsistent. This study aims to clarify the relationship between dietary oleic acid intake and the risk of developing PDA using nutritional information from food diaries plus published serum biomarker data from HbA1c.

METHODS:

23,658 participants, aged 40-74 years, were recruited into EPIC-Norfolk and completed 7-day food diaries which recorded; foods, brands and portion sizes to calculate nutrient intakes. Serum HbA1c was measured at recruitment in 11,147 participants (48.7% of cohort). Hazard ratios (HRs) for quintiles of dietary oleic acid intake and serum HbA1c were estimated using Cox regression. Additional analyses were made according to whether body mass index (BMI) was greater or less than 25 kg/m2 as this influences hyperinsulinaemia.

RESULTS:

88 participants (55% women) developed PDA after a mean follow-up of 8.4 years (SD = 3.9) (mean age at diagnosis = 72.6 years, SD = 8.8). A decreased risk of PDA was associated with increased dietary oleic acid intake (highest vs lowest quintile, HR = 0.29, 95% CI = 0.10-0.81, P trend across quintiles = 0.011), with statistical significance maintained when BMI>25 kg/m2 but not if BMI<25 kg/m2. An elevated serum HbA1c was associated with increased risk of disease (highest vs lowest quintiles, HR = 6.32, 95% CI = 1.38-28.89, P for trend = 0.004).

CONCLUSIONS:

The data supports a protective role of oleic acid against development of PDA in those with higher BMIs possibly through influencing hyperinsulinaemia. Oleic acid intake should be accurately measured in future aetiological studies.

 

A Systematic Review of Renal Health in Healthy Individuals Associated with Protein Intake above the US Recommended Daily Allowance in Randomized Controlled Trials and Observational Studies.

Van Elswyk ME, Weatherford CA, McNeill SH.

Adv Nutr. 2018 Jul 1;9(4):404-418. doi: 10.1093/advances/nmy026.

PMID: 30032227

Abstract

A systematic review was used to identify randomized controlled trials (RCTs) and observational epidemiologic studies (OBSs) that examined protein intake consistent with either the US RDA (0.8 g/kg or 10-15% of energy) or a higher protein intake (≥20% but <35% of energy or ≥10% higher than a comparison intake) and reported measures of kidney function. Studies (n = 26) of healthy, free-living adults (>18 y old) with or without metabolic disease risk factors were included. Studies of subjects with overt disease, such as chronic kidney, end-stage renal disease, cancer, or organ transplant, were excluded. The most commonly reported variable was glomerular filtration rate (GFR), with 13 RCTs comparing GFRs obtained with normal and higher protein intakes. Most (n = 8), but not all (n = 5), RCTs reported significantly higher GFRs in response to increased protein intake, and all rates were consistent with normal kidney function in healthy adults. The evidence from the current review is limited and inconsistent with regard to the role of protein intake and the risk of kidney stones. Increased protein intake had little or no effect on blood markers of kidney function. Evidence reported here suggests that protein intake above the US RDA has no adverse effect on blood pressure. All included studies were of moderate to high risk of bias and, with the exception of 2 included cohorts, were limited in duration (i.e. <6 mo). Data in the current review are insufficient to determine if increased protein intake from a particular source, i.e., plant or animal, influences kidney health outcomes. These data further indicate that, at least in the short term, higher protein intake within the range of recommended intakes for protein is consistent with normal kidney function in healthy individuals.

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Pneumococcal Disease and the Effectiveness of the PPV23 Vaccine in Adults: A Two-Stage Bayesian Meta-Analysis of Observational and RCT Reports.

Latifi-Navid H, Latifi-Navid S, Mostafaiy B, Jamalkandi SA, Ahmadi A.

Sci Rep. 2018 Jul 23;8(1):11051. doi: 10.1038/s41598-018-29280-2.

PMID: 30038423

https://www.nature.com/articles/s41598-018-29280-2.pdf

Abstract

The efficacy of PPV-23 vaccine on outcomes of pneumococcal disease in adults still remains controversial due mainly to the lack of consistency between the results obtained from observational studies(OSs) and those obtained from randomized controlled trials(RCTs). As a consequence, the complexity in the structure of evidence available, in turn, generates a challenge for combining disparate pieces of evidence quantitatively. In this regard, we used a hierarchical Bayesian inference-based evidence synthesis of RCTs and observational data using a two-stage approach (in addition to a traditional random-effects meta-analysis) to examine the effectiveness of PPV-23 in adults. To this end, 21 studies were included involving 826109 adult participants. By a two-stage Bayesian meta-analysis, which was directly used for combining studies of different designs, the overall log OR (95% credible interval) for IPDs was -0.1048 (-0.3920,-0.0250), indicating a significant protective effect of the vaccination against IPDs. No significant effect of PPV-23 was found on all-cause pneumonia, pneumococcal pneumonia, and death from pneumonia, which confirmed the results obtained by a traditional method followed by stratified and sensitivity analyses. The estimated overall log OR (95% credible interval) was -0.0002 (-0.0241,0.0142), -0.0002 (-0.0110,0.0122), and -6.3912 × 10-5 (-0.0219,0.0131), respectively. The PPV-23 vaccine might be effective in preventing the most severe invasive forms of pneumococcal diseases, but not effective in preventing other clinical outcomes, in the adult population of 18 years and older.

 

Dietary Protein, Muscle and Physical Function in the Very Old.

Franzke B, Neubauer O, Cameron-Smith D, Wagner KH.

Nutrients. 2018 Jul 20;10(7). pii: E935. doi: 10.3390/nu10070935. Review.

PMID: 30037048

http://www.mdpi.com/2072-6643/10/7/935/htm

Abstract

There is an ongoing debate as to the optimal protein intake in older adults. An increasing body of experimental studies on skeletal muscle protein metabolism as well as epidemiological data suggest that protein requirements with ageing might be greater than many current dietary recommendations. Importantly, none of the intervention studies in this context specifically investigated very old individuals. Data on the fastest growing age group of the oldest old (aged 85 years and older) is very limited. In this review, we examine the current evidence on protein intake for preserving muscle mass, strength and function in older individuals, with emphasis on data in the very old. Available observational data suggest beneficial effects of a higher protein intake with physical function in the oldest old. Whilst, studies estimating protein requirements in old and very old individuals based on whole-body measurements, show no differences between these sub-populations of elderly. However, small sample sizes preclude drawing firm conclusions. Experimental studies that compared muscle protein synthetic (MPS) responses to protein ingestion in young and old adults suggest that a higher relative protein intake is required to maximally stimulate skeletal muscle MPS in the aged. Although, data on MPS responses to protein ingestion in the oldest old are currently lacking. Collectively, the data reviewed for this article support the concept that there is a close interaction of physical activity, diet, function and ageing. An attractive hypothesis is that regular physical activity may preserve and even enhance the responsiveness of ageing skeletal muscle to protein intake, until very advanced age. More research involving study participants particularly aged ≥85 years is warranted to better investigate and determine protein requirements in this specific growing population group.

KEYWORDS:

ageing; amino acids; anabolic resistance; centenarians; exercise; nonagenarians; octogenarians; protein requirements; skeletal muscle health

 

Weight loss and metabolic health effects from energy-restricted Mediterranean and Central-European diets in postmenopausal women: A randomized controlled trial.

Bajerska J, Chmurzynska A, Muzsik A, Krzyżanowska P, Mądry E, Malinowska AM, Walkowiak J.

Sci Rep. 2018 Jul 24;8(1):11170. doi: 10.1038/s41598-018-29495-3.

PMID: 30042488

https://www.nature.com/articles/s41598-018-29495-3.pdf

Abstract

We conducted a randomized controlled trial to examine the effect of two energy-restricted diets on body weight (BW), visceral fat (VF) loss, and the risk factors for metabolic syndrome. A total of 144 centrally obese postmenopausal women were assigned to the moderate in fat Mediterranean diet (MED) or to the Central European diet (CED), which is moderate in carbohydrates and high in dietary fiber (DF), for 16 weeks. BW, waist circumference and VF were significantly reduced by 8.8%, 7.0%, and 24.6%, respectively, over the trial (P < 0.001), with no difference between groups. A similar trend was seen for total cholesterol, triglycerides, glucose, and blood pressure. Within each diet group, the more adherent participants lost significantly more BW than did their less adherent counterparts. VF was significantly reduced only in women who were more adherent to the CED, and the reduction in VF correlated with an increase in the proportion of DF. Short-term dietary treatment with the CED or the MED was associated with similar improvements in some anthropometric, lipid, and nonlipid parameters; however, adequate adherence to the prescribed diet is important in weight loss success and in achieving improvements in metabolic health.

 

Ageing: Is there a role for arachidonic acid and other bioactive lipids? A review.

Das UN.

J Adv Res. 2018 Feb 15;11:67-79. doi: 10.1016/j.jare.2018.02.004. eCollection 2018 May. Review.

PMID: 30034877 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052661/pdf/main.pdf

Abstract

Ageing is inevitable. Recent studies suggest that it could be delayed. Low-grade systemic inflammation is seen in type 2 diabetes mellitus, hypertension and endothelial dysfunction that are common with increasing age. In all these conditions, an alteration in arachidonic acid (AA) metabolism is seen in the form of increased formation of pro-inflammatory eicosanoids and decreased production of anti-inflammatory lipoxins, resolvins, protectins and maresins and decreased activity of desaturases. Calorie restriction, exercise and parabiosis delay age-related changes that could be related to enhanced proliferation of stem cells, decrease in inflammation and transfer of GDF-11 (growth differentiation factor-11) and other related molecules from the young to the old, increase in the formation of lipoxin A4, resolvins, protectins and maresins, hydrogen sulfide (H2S) and nitric oxide (NO); inhibition of ageing-related hypothalamic or brain IKK-β and NF-kB activation, decreased gonadotropin-releasing hormone (GnRH) release resulting in increased neurogenesis and consequent decelerated ageing. This suggests that hypothalamus participates in ageing process. N-acylethanolamines (NAEs) and lipid-derived signalling molecules can be tuned favorably under dietary restriction to extend lifespan and/or prevent advanced age associated diseases in an mTOR dependent pathway manner. Sulfur amino acid (SAA) restriction increased hydrogen sulfide (H2S) production and protected tissues from hypoxia and tissue damage. Anti-inflammatory metabolites formed from AA such as LXA4, resolvins, protectins and maresins enhance production of NO, CO, H2S; suppress NF-kB expression and alter mTOR expression and thus, may aid in delaying ageing process. Dietary restriction and exercise enhance AA metabolism to form LXA4, resolvins, protectins and maresins that have anti-inflammatory actions. AA and their metabolites also influence stem cell biology, enhance neurogenesis to improve memory and augment autophagy to prolong life span. Thus, AA and other PUFAs and their anti-inflammatory metabolites inhibit inflammation, augment stem cell proliferation, restore to normal lipid-derived signaling molecules and NO and H2S production, enhance autophagy and prolong life span.

KEYWORDS:

Ageing; Arachidonic acid; Calorie restriction; GDF-11; Hydrogen sulfide; Hypothalamus; Inflammation; Lipids; Nitric oxide; Polyunsaturated fatty acids; Stem cells; Sulfur amino acid

 

mTOR Inhibitor Therapy and Metabolic Consequences: Where Do We Stand?

Kezic A, Popovic L, Lalic K.

Oxid Med Cell Longev. 2018 Jun 24;2018:2640342. doi: 10.1155/2018/2640342. eCollection 2018. Review.

PMID: 30034573 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035806/

Abstract

mTOR (mechanistic target of rapamycin) protein kinase acts as a central integrator of nutrient signaling pathways. Besides the immunosuppressive role after solid organ transplantations or in the treatment of some cancers, another promising role of mTOR inhibitor as an antiaging therapeutic has emerged in the recent years. Acute or intermittent rapamycin treatment has some resemblance to calorie restriction in metabolic effects such as an increased insulin sensitivity. However, the chronic inhibition of mTOR by macrolide rapamycin or other rapalogs has been associated with glucose intolerance and insulin resistance and may even provoke type II diabetes. These metabolic adverse effects limit the use of mTOR inhibitors. Metformin is a widely used drug for the treatment of type 2 diabetes which activates AMP-activated protein kinase (AMPK), acting as calorie restriction mimetic. In addition to the glucose-lowering effect resulting from the decreased hepatic glucose production and increased glucose utilization, metformin induces fatty acid oxidations. Here, we review the recent advances in our understanding of the metabolic consequences regarding glucose metabolism induced by mTOR inhibitors and compare them to the metabolic profile provoked by metformin use. We further suggest metformin use concurrent with rapalogs in order to pharmacologically address the impaired glucose metabolism and prevent the development of new-onset diabetes mellitus after solid organ transplantations induced by the chronic rapalog treatment.

 

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rospective Association Between Nut Consumption and Physical Function in Older Men and Women.
Arias-Fernández L, Machado-Fragua MD, Graciani A, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F, Lana A, Lopez-Garcia E.
J Gerontol A Biol Sci Med Sci. 2018 Jul 21. doi: 10.1093/gerona/gly171. [Epub ahead of print]
PMID: 30052782
Abstract
BACKGROUND:
The beneficial effect of nut consumption preventing cardio-metabolic diseases and cancer suggests that nuts might also protect from physical function impairment in older people, since aging-related functional decline shares biological pathways with these chronic diseases. The objective was to examine the association between nut consumption and impairment of physical function in older adults.
METHODS:
Prospective study with 3,289 individuals aged ≥60 years from the Seniors-ENRICA cohort. In 2008-2010 and 2012 nut consumption was measured with a validated diet history. Participants were followed-up until 2015 to ascertain incident impaired physical function, specifically impaired agility, mobility, grip strength, gait speed and overall physical function. Statistical analyses were performed with Cox regression and adjusted for the main confounders, including a wide set of socioeconomic, lifestyle, dietary and morbidity variables.
RESULTS:
Overall, 65.7% of participants consumed any type of nuts. The mean intake among nut consumers was 15.1 g/d in men and 14.6 g/d in women. Median consumption of nuts was 11.5 g/d in both sexes. Men consuming ≥11.5 g/d of nuts had lower risk of impaired agility and mobility than those who did not consume nuts; the hazard ratios (95% confidence interval; p for linear trend) were 0.59 (0.39-0.90; p=0.01) and 0.50 (0.29-0.90; p=0.02), respectively. In women, compared to non-consumers, the hazard ratio (95% confidence interval; p for linear trend) of impaired overall physical function for nut intake ≥11.5 g/d was 0.65 (0.48-0.87; p=0.004). No association was observed between nut consumption and low grip strength and slow gait speed.
CONCLUSIONS:
Nut consumption was associated with half the risk of impaired agility and mobility in men and with lower risk of overall physical function impairment in women. The suggested protective effect of nut consumption on physical functioning merits further examination.

Cholecalciferol or 25-Hydroxycholecalciferol Supplementation Does Not Affect Muscle Strength and Physical Performance in Prefrail and Frail Older Adults.
Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot LCPGM.
J Nutr. 2018 May 1;148(5):712-720. doi: 10.1093/jn/nxy024.
PMID: 30053278

Physical Activity, Sitting Time, and Mortality From Inflammatory Diseases in Older Adults.
Cabanas-Sánchez V, Guallar-Castillón P, Higueras-Fresnillo S, García-Esquinas E, Rodríguez-Artalejo F, Martinez-Gomez D.
Front Physiol. 2018 Jul 12;9:898. doi: 10.3389/fphys.2018.00898. eCollection 2018.
PMID: 30050463
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052124/pdf/fphys-09-00898.pdf
Abstract
Objective: The aim of this study was to examine the independent and combined associations of physical activity (PA) and sitting time (ST) with long-term mortality attributed to inflammatory causes other than cardiovascular disease (CVD) and cancer in a national cohort of older adults in Spain. Design: Prospective study. Setting and Participants: A cohort of 3,677 individuals (1,626 men) aged ≥60 years was followed-up during 14.3 years. Measures: At baseline, individuals reported PA and ST. The study outcome was death from inflammatory diseases when CVD or cancer mortality was excluded. This outcome was classified into infectious and non-infectious conditions. Analyses were performed with Cox regression and adjusted for PA, ST, and other main confounders (age, sex, educational level, smoking, alcohol consumption, body mass index, and chronic conditions). Results: During follow-up, 286 deaths from inflammatory diseases (77 from infectious diseases) were identified. Compared to individuals who defined themselves as inactive/less active, mortality from inflammatory diseases was lower in those who were moderately active (hazard ratio {HR} = 0.67, 95% confidence interval [CI] = 0.50-0.90) or very active (HR = 0.48, 95%CI = 0.33-0.68), independently of ST. Also, being seated ≥7 h/d vs. <7 h/d was linked to higher mortality (HR = 1.38, 95%CI = 1.02-1.87). The largest risk of mortality was observed in inactive/less active individuals with ST≥7 h/d (HR = 2.29, 95%CI = 1.59-3.29) compared to those with moderate/very PA and ST <7 h/d. Low PA and high ST were consistently associated with a higher risk of mortality from non-infectious inflammatory causes. Associations of PA and ST with mortality from infectious inflammatory causes showed a similar trend, but most of them did not reach statistical significance. Conclusions: Low PA and high ST were independently associated with higher mortality from inflammatory diseases other than CVD or cancer in older adults. Interventions addressing simultaneously both behaviors could have greater benefits than those focusing on only one of them.
KEYWORDS:
infectious diseases; inflammation diseases; mortality; physical activity; sitting time

Concentrated sugars and incidence of prostate cancer in a prospective cohort.
Miles FL, Neuhouser ML, Zhang ZF.
Br J Nutr. 2018 Jul 26:1-8. doi: 10.1017/S0007114518001812. [Epub ahead of print]
PMID: 30047347
Abstract
The association between consumption of added or concentrated sugars and prostate cancer risk is unclear. We examined the association between concentrated sugars in beverages and desserts and prostate cancer risk among 22 720 men in the usual-care arm of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, enrolled during 1993-2001. After a median follow-up of 9 years, 1996 men were diagnosed with prostate cancer. Cox proportional hazards regression models were used to estimate hazard ratios (HR) for prostate cancer risk and 95 % CI, adjusting for potential confounding factors. Increased consumption of sugars from sugar-sweetened beverages was associated with increased risk of prostate cancer for men in the highest quartile of sugar consumption (HR: 1·21; 95 % CI 1·06, 1·39), and there was a linear trend (P<0·01). There were no linear associations between prostate cancer risk and consumption of sugars from fruit juices or dessert foods. In conclusion, in this prospective substudy within the PLCO trial, consumption of sugars from sugar-sweetened beverages was associated with increased risk of prostate cancer among men receiving standard medical care. Our study suggests that limiting intake of sugars from beverages may be important in the prevention of prostate cancer.
KEYWORDS:
Colorectal and Ovarian; DHQ diet history questionnaire; HR hazard ratio; Lung; PLCO Prostate; PSA prostate-specific antigen; Added sugars; Proportional hazards regression; Prospective cohorts; Prostate cancer risk

Ten Lifestyle Modification Approaches to Treat Atrial Fibrillation.
Sabzwari SRA, Garg L, Lakkireddy D, Day J.
Cureus. 2018 May 24;10(5):e2682. doi: 10.7759/cureus.2682. Review.
PMID: 30050737
Abstract
Atrial fibrillation (AF) is the most common arrhythmia affecting three million people in the United States (US). Across different races in the US, the incidence of other races was comparable to that of Caucasian population. This points towards the importance of certain lifestyle modifications that can help prevent and treat this disorder. This article discusses 10 such factors. Smoking has been linked to AF, with almost 36% risk reduction if quit. Hypertension has 56% increased risk of atrial fibrillation in which the role of lifestyle changes is well known. Similarly, alcohol-induced atrial fibrillation has 10% increased risk of atrial fibrillation. On the other hand, several case reports document red bull as the cause of atrial fibrillation. Moreover, the risk of atrial fibrillation is four times higher in patients with obstructive sleep apnea (OSA) independent of other confounding variables. Additionally, it has been shown that acute sleep deprivation increases AF risk by 3.36 times. Furthermore, diabetes mellitus and obesity also contribute greatly to atrial fibrillation. This risk has been shown to be around 40% more with diabetes. Diet itself has an impact: numerous studies have shown Mediterranean diet to reduce the risk of AF and cerebrovascular accident in addition to olive oil, fruits and vegetables. Even emotions are important with 85% less AF on 'happy days'. Needless to mention, yoga has been well demonstrated to have almost 24% reduction in AF. Similarly, physical activity in all forms is beneficial. In summary, lifestyle modifications reduce the incidence of AF, induce more AF remission and also produce successful ablation outcomes.
KEYWORDS:
atrial fibrillation; lifestyle modification

The Relationship Between Dietary Macronutrients and Hepatic Telomere Length in Aging Mice.
Gokarn R, Solon-Biet S, Youngson NA, Wahl D, Cogger VC, McMahon AC, Cooney GJ, Ballard JWO, Raubenheimer D, Morris MJ, Simpson SJ, Le Couteur DG.
J Gerontol A Biol Sci Med Sci. 2018 Mar 14;73(4):446-449. doi: 10.1093/gerona/glx186.
PMID: 30052781
Abstract
Macronutrients and dietary energy influence aging, age-related health, and life span. Reduction in telomere length has been proposed as one mechanism for aging. Therefore, this study investigated the effects of varying ratios of dietary macronutrients and energy on telomere length in older adult mice. C57Bl/6 mice were fed ad libitum their entire life on one of 25 diets varying in protein, carbohydrates, fat, and energy. Average telomere length ratio (ATLR) was measured by polymerase chain reaction in livers of a subset of 161 mice aged 15 months. There was a significant positive relationship between ATLR and carbohydrate intake and a negative relationship with protein intake, but no relationships with fat or energy intake. Analysis using the Geometric Framework and Generalized Additive Models confirmed that carbohydrate intake was positively associated with ATLR, while the longest ATLR was achieved by mice restricted to low protein, high carbohydrate diets. ATLR distribution across the diets was parallel to median life-span results previously published. ATLR was associated with blood levels of some amino acids (asparagine, glutamate, taurine) but not with blood levels of fatty acids, hepatic mitochondrial function, or nutrient sensing pathways. In conclusion, mice on low protein, high carbohydrate diets have the longest hepatic telomeres and longest life span.

A Clinician's Guide for Trending Cardiovascular Nutrition Controversies: Part II.
Freeman AM, Morris PB, Aspry K, Gordon NF, Barnard ND, Esselstyn CB, Ros E, Devries S, O'Keefe J, Miller M, Ornish D, Williams KA, Batts T, Ostfeld RJ, Litwin S, Aggarwal M, Werner A, Allen K, White B, Kris-Etherton P.
J Am Coll Cardiol. 2018 Jul 31;72(5):553-568. doi: 10.1016/j.jacc.2018.05.030. Review.
PMID: 30049315
https://sci-hub.tw/
Abstract
The potential cardiovascular (CV) benefits of many trending foods and dietary patterns are still incompletely understood, and scientific inquiry continues to evolve. In the meantime, however, a number of controversial dietary patterns, foods, and nutrients have received significant media attention and are mired by "hype." This second review addresses some of the more recent popular foods and dietary patterns that are recommended for CV health to provide clinicians with current information for patient discussions in the clinical setting. Specifically, this paper delves into dairy products, added sugars, legumes, coffee, tea, alcoholic beverages, energy drinks, mushrooms, fermented foods, seaweed, plant and marine-derived omega-3-fatty acids, and vitamin B12.
KEYWORDS:
B12; OM3; coffee; dairy; dairy products; energy drinks; fermented foods; fish oil; healthy dietary patterns; legumes; mushrooms; nutrition; seaweed; tea

Non-linear associations between sleep duration and the risks of mild cognitive impairment/dementia and cognitive decline: a dose-response meta-analysis of observational studies.
Liang Y, Qu LB, Liu H.
Aging Clin Exp Res. 2018 Jul 23. doi: 10.1007/s40520-018-1005-y. [Epub ahead of print] Review.
PMID: 30039452
https://sci-hub.tw/
Abstract
BACKGROUND:
Mount evidence from observational studies suggested that associations between sleep duration and the risks of mild cognitive impairment (MCI)/dementia or cognitive decline had been recognized.
METHODS:
To explore the precise and continuous effect of sleep duration on these risks, we conducted a dose-response meta-analysis to quantitatively assess it.
RESULTS:
Five prospective cohort studies and 4 cross-sectional studies were eligible for inclusion criteria, which involved 62937 individuals, and documented 2718 MCI/dementia cases and 5596 cognitive decline cases. The pooled RR per 1 h increases in sleep duration was 0.99 (95% CI 0.97-1.01, I2 = 62.40%, P = 0.02, n = 6) for cognitive decline risk, and 0.98 (95% CI 0.97-1.00, I2 = 0%, P = 0.42, n = 4) for MCI/dementia risk. Similar U-shaped non-linear relationship of sleep duration and the risks of MCI/dementia and cognitive decline was revealed, respectively (all Pnon-linearity < 0.001), whose peaks are approximately 7 h.
CONCLUSION:
In conclusion, 7 h sleep duration tends to acquire the least risk of MCI/dementia or cognitive decline; however, more well-designed randomized controlled trials are urgently needed to balance potential modifiers.
KEYWORDS:
Cognitive decline; Dementia; Dose–response; Meta-analysis; Mild cognitive impairment (MCI); Sleep duration

Sedentary behaviors, physical activity, and changes in depression and psychological distress symptoms in older adults.
Andrade-Gómez E, Martínez-Gómez D, Rodríguez-Artalejo F, García-Esquinas E.
Depress Anxiety. 2018 Jul 24. doi: 10.1002/da.22804. [Epub ahead of print]
PMID: 30040170
Abstract
BACKGROUND:
Television (TV) viewing and computer use have been associated with higher risk of depression, but studies specifically assessing the impact of these and other types of sedentary behaviors (SBs) on the mental health of older adults are scarce and their results are inconclusive. Similarly, the association between specific types of recreational physical activity (rPA) and mental health in older adults is poorly understood.
METHODS:
In 2012, information on SBs, rPA, and other health behaviors was collected with validated questionnaires from community-dwelling older adults participating in the Seniors-ENRICA cohort. In 2012 and 2015, symptoms of depression and mental distress were assessed using the GDS-10 and the General Health Questionnaire-12 (GHQ-12), respectively.
RESULTS:
Time spent watching TV was prospectively associated with higher (worse) GDS-10 scores in women (β [95% confidence interval (CI)] comparing the second and third tertiles of TV viewing to the first: 0.21 [-0.04 to 0.46] and 0.37 [0.13-0.62], respectively; P-trend: < 0.01), but not in men (-0.11 [-0.35 to 0.13] and -0.18 [-0.44 to 0.08]; P-trend: 0.16). Women, but not men, who spent more time in other SBs, including reading, using the computer and commuting, showed a lower number of depressive symptoms (-0.19 [-0.44 to 0.06] and -0.34 [-0.60 to -0.08]; P-trend: 0.01) and lower (better) GHQ-12 scores (-0.33 [-0.67 to -0.00] and -0.35 [-0.69 to -0.00]; P-trend: 0.05) at follow-up. Both in men and women, higher levels of rPA, such as walking, practicing sports, and do-it-yourself activities, were associated with lower GDS-10 scores (-0.07 [-0.25 to 0.11] and -0.19 [-0.36 to -0.01]; P-trend: 0.04) and with lower GHQ-12 scores (-0.02 [-0.26 to 0.22] and -0.23 [-0.47 to -0.00]; P-trend: 0.06).
CONCLUSIONS:
Older women who spent more time watching TV and less time in other SBs showed a higher number of depressive symptoms. Data suggest that increasing rPA may improve mental health in older adults, particularly among women.
KEYWORDS:
depression; psychological distress; recreational physical activity; sedentariness

Association of macronutrient consumption with arterial aging in adults without clinically overt cardiovascular disease: a 5-year prospective cohort study.
Georgiopoulos G, Karatzi K, Euthimiou E, Laina A, Kontogiannis C, Mareti A, Mavroeidis I, Kouzoupis A, Mitrakou A, Papamichael C, Stamatelopoulos K.
Eur J Nutr. 2018 Jul 23. doi: 10.1007/s00394-018-1781-3. [Epub ahead of print]
PMID: 30039435
Abstract
PURPOSE:
There is limited and inconsistent evidence regarding longitudinal effects of macronutrients on blood pressure (BP) haemodynamics and arterial aging in populations without cardiovascular disease (CVD). We aimed to prospectively investigate potential association of dietary macronutrients with long-term changes in peripheral and central haemodynamics and arterial stiffness.
METHODS:
One hundred and fifteen subjects (46.7 ± 8.73 years, 70 women), free of clinically overt CVD were consecutively recruited. Dietary macronutrient intake was evaluated using 3-day food records at baseline. Aortic stiffness and arterial wave reflections were assessed at baseline and in one follow-up visit 5 years later by pulse wave velocity (PWV) and augmentation index (AI), respectively.
RESULTS:
Individuals with the highest consumption of saturated fatty acids (SFA) presented the highest rate of progression in PWV, AI and aortic diastolic BP (p < 0.05 for all) after adjustment for age, gender, smoking, body mass index, hyperlipidemia, insulin resistance, changes in systolic BP and treatment with antihypertensive and hypolipidemic drugs. After similar multivariable adjustments, high consumption of carbohydrates was associated with higher progression of AI, whereas high consumption of monounsaturated fatty acids (MUFA) and fibre with lower progression in aortic and peripheral systolic and diastolic BP (p < 0.05 for all).
CONCLUSIONS:
In subjects without CVD, high consumption of SFA is related to accelerated arterial stiffening, while high consumption of MUFA and fibre and low intake of carbohydrates is associated with attenuated progression in blood pressure and arterial wave reflections, respectively. These findings expand current knowledge on the association of macronutrient consumption with arterial aging in the general population.
KEYWORDS:
Arterial stiffness; Carbohydrates; Fatty acids; Fibre; Haemodynamics; Monounsaturated fatty acids

Long-Term, Supplemental, One-Carbon Metabolism-Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort.
Brasky TM, White E, Chen CL.
J Clin Oncol. 2017 Oct 20;35(30):3440-3448. doi: 10.1200/JCO.2017.72.7735. Epub 2017 Aug 22.
PMID: 28829668
Abstract
Purpose Inconsistent findings have been reported of a link between the use of one-carbon metabolism-related B vitamins and lung cancer risk. Because of the high prevalence of supplemental vitamin B use, any possible increased association warrants further investigation. We examined the association between long-term use of supplemental B vitamins on the one-carbon metabolism pathway and lung cancer risk in the Vitamins and Lifestyle (VITAL) cohort, which was designed specifically to look at supplement use relative to cancer risk. Methods A total of 77,118 participants of the VITAL cohort, 50 to 76 years of age, were recruited between October 2000 and December 2002 and included in this analysis. Incident, primary, invasive lung cancers (n = 808) were ascertained by prospectively linking the participants to a population-based cancer registry. The 10-year average daily dose from individual and multivitamin supplements were the exposures of primary interest. Results Use of supplemental vitamins B6, folate, and B12 was not associated with lung cancer risk among women. In contrast, use of vitamin B6 and B12 from individual supplement sources, but not from multivitamins, was associated with a 30% to 40% increase in lung cancer risk among men. When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers. For vitamin B6 and B12, the risk was even higher among men who were smoking at baseline. In addition, the B6 and B12 associations were apparent in all histologic types except adenocarcinoma, which is the type less related to smoking. Conclusion This sex- and source-specific association provides further evidence that vitamin B supplements are not chemopreventive for lung cancer and may be harmful.

Caffeine Transiently Affects Food Intake at Breakfast.
Panek-Shirley LM, DeNysschen C, O'Brien E, Temple JL.
J Acad Nutr Diet. 2018 Jul 16. pii: S2212-2672(18)30768-8. doi: 10.1016/j.jand.2018.05.015. [Epub ahead of print]
PMID: 30033159
Abstract
BACKGROUND:
Caffeine is frequently added to dietary supplements with claims it facilitates weight loss.
OBJECTIVE:
The purpose of this study was to test the hypothesis that caffeine administration reduces laboratory and free-living food intake by reducing appetite and that these effects vary by body mass index (BMI).
PARTICIPANTS/SETTING:
Fifty adults aged 18 to 50 years completed the study (42% male). Exclusion criteria included no previous experience with caffeine, previous adverse event following caffeine consumption, taking any medications or having a medical condition contraindicating caffeine or stimulant consumption or affecting appetite or eating, and reported tobacco use within the past 6 months.
DESIGN AND INTERVENTION:
Participants visited the laboratory on four separate occasions to complete a double-blind, placebo-controlled, randomized, crossover study. On the first three visits, participants consumed a beverage containing 0, 1, or 3 mg/kg caffeine (order randomized). Thirty minutes later, participants consumed a buffet breakfast, ad libitum. After leaving the laboratory, participants completed hourly appetite assessments and dietary habit books until midnight or bedtime. The fourth session consisted of questionnaires, debriefing, and compensation.
MAIN OUTCOME MEASURES:
Total and macronutrient intake and appetite sensations in and out of the laboratory were measured.
STATISTICAL ANALYSES PERFORMED:
Intake data were analyzed using mixed analysis of covariance (ANCOVA). Appetite sensations were analyzed using repeated measures mixed ANCOVA.
RESULTS:
Total laboratory energy intake was lower (∼10%) after 1 mg/kg caffeine (650.4±52.2 kcal at 1 mg/kg; 721.2±63.2 at 0 mg/kg; 714.7±79.0 at 3 mg/kg) (P=0.046). In the laboratory, appetite sensations were not significantly different by caffeine treatment. Out of the laboratory, neither total intake nor appetite was significantly different by caffeine treatment. There were no significant interactions between caffeine treatment and BMI on intake and appetite sensations in or out of the laboratory.
CONCLUSIONS:
These results suggest caffeine has weak, transient effects on energy intake and do not support caffeine as an effective appetite suppressant.
KEYWORDS:
Appetite; Body mass index; Caffeine; Energy intake; Supplements


Effects of Lipid-Lowering and Antihypertensive Treatments in Addition to Healthy Lifestyles in Primary Prevention: An Analysis of the HOPE-3 Trial.
Dagenais GR, Jung H, Lonn E, Bogaty PM, Dehghan M, Held C, Avezum A, Jansky P, Keltai M, Leiter LA, Lopez-Jaramillo P, Toff WD, Bosch J, Yusuf S.
J Am Heart Assoc. 2018 Jul 22;7(15). pii: e008918. doi: 10.1161/JAHA.118.008918.
PMID: 30033433 Free Article
Abstract
BACKGROUND:
It is not clear whether the effects of lipid-lowering or antihypertensive medications are influenced by adherence to healthy lifestyle factors. We assessed the effects of both drug interventions in subgroups by the number of healthy lifestyle factors in participants in the HOPE-3 (Heart Outcomes Prevention Evaluation) trial.
METHODS AND RESULTS:
In this primary prevention trial, 4 healthy lifestyle factors (nonsmoking status, physical activity, optimal body weight, and healthy diet) were recorded in 12 521 participants who were at intermediate risk of cardiovascular disease (CVD) and were randomized to rosuvastatin, candesartan/hydrochlorothiazide, their combination, or matched placebos. Median follow-up was 5.6 years. The outcome was a composite of CVD events. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. Participants with ≥2 healthy lifestyle factors had a lower rate of CVD compared with those with fewer factors (HR: 0.85; 95% CI, 0.73-1.00). Rosuvastatin reduced CVD events in participants with ≥2 healthy lifestyle factors (HR: 0.74; 95% CI, 0.62-0.90) and in participants with <2 factors (HR: 0.79; 95% CI, 0.61-1.01). Consistent results were observed with combination therapy (≥2 factors: HR: 0.74; 95% CI, 0.57-0.97; <2 factors: HR: 0.61; 95% CI, 0.43-0.88). Candesartan/hydrochlorothiazide tends to reduce CVD only in participants with <2 healthy lifestyle factors (HR: 0.78; 95% CI, 0.61-1.00).
CONCLUSIONS:
Healthy lifestyles are associated with lower CVD. Rosuvastatin alone and combined with candesartan/hydrochlorothiazide is beneficial regardless of healthy lifestyle status; however, the benefit of antihypertensive treatment appears to be limited to patients with less healthy lifestyles.
CLINICAL TRIAL REGISTRATION:
URL: https://www.clinicaltrials.gov. Unique identifier: NCT00239681.
KEYWORDS:
antihypertensive agent; statin

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Nonlinear associations between dietary exposures to perfluorooctanoic acid (PFOA) or perfluorooctane sulfonate (PFOS) and type 2 diabetes risk in women: Findings from the E3N cohort study.
Mancini FR, Rajaobelina K, Praud D, Dow C, Antignac JP, Kvaskoff M, Severi G, Bonnet F, Boutron-Ruault MC, Fagherazzi G.
Int J Hyg Environ Health. 2018 Jul 25. pii: S1438-4639(18)30294-3. doi: 10.1016/j.ijheh.2018.07.007. [Epub ahead of print]
PMID: 30056006
http://sci-hub.tw/http://www.sciencedirect.com/science/article/pii/S1438463918302943
Abstract
The incidence of type 2 diabetes (T2D) is steadily rising worldwide since the past 30 years. There is increasing interest in understanding the contribution of exposure to endocrine disrupting chemicals (EDCs) to T2D trend. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) are stable, persistent, and bioaccumulative synthetic compounds, suspected to act as EDCs and for which the diet is the main route of exposure. We investigated associations between estimated dietary exposure to PFOS and PFOA and the risk of T2D in the large E3N prospective cohort study. Among 71 270 women included in this study, 2680 cases of incident type 2 diabetes were validated during follow-up (1993-2012). Dietary exposure was estimated combining dietary consumption data collected in E3N and food contamination data provided by ANSES in the 2nd French Total Diet Study. The estimated mean dietary exposure to PFOS and PFOA was 0.50 ng/kg body weight/day and 0.86 ng/kg body weight/day respectively. An inverse U-shape association was found when considering PFOA and T2D: women in the 4th, 5th, and 6th decile groups had a HR [95%CI] of 1.21 [1.06-1.46], 1.35 [1.15-1.59], and 1.33 [1.05-1.41], respectively, when compared to women of the 1st decile group, while the other decile groups were not associated to the risk of T2D. The positive association had the strongest effect size for non-obese women (body mass index (BMI) ≤25 kg/m2). No association was found between dietary exposure to PFOS and T2D, except when considering only women with BMI≤25 kg/m2, in which a positive nonlinear association was observed (HR [95%CI] = 1.46 [1.09-1.96], 1.52 [1.09-2.11], and 1.44 [1.01-2.06] for the 6th, 8th, and 9th decile groups respectively). This is the first study to evaluate the association between dietary exposure to PFOA and PFOS and the risk of developing T2D in a large observational study with over 15 years of follow-up. The present study highlights the importance of studying the effects of EDCs in large epidemiological studies including not occupationally exposed populations, as well as the importance of considering exposure to PFOS and PFOA as a relevant risk factor for T2D.
KEYWORDS:
Dietary exposure; Perfluorooctane sulfonate (PFOS); Perfluorooctanoic acid (PFOA); Type 2 diabetes

Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies.
Veronese N, Stubbs B, Volpato S, Zuliani G, Maggi S, Cesari M, Lipnicki DM, Smith L, Schofield P, Firth J, Vancampfort D, Koyanagi A, Pilotto A, Cereda E.
J Am Med Dir Assoc. 2018 Jul 25. pii: S1525-8610(18)30327-X. doi: 10.1016/j.jamda.2018.06.007. [Epub ahead of print]
PMID: 30056008
Abstract
OBJECTIVES:
Slow gait speed may be associated with premature mortality, cardiovascular disease (CVD), and cancer, although a comprehensive meta-analysis is lacking. In this systematic review and meta-analysis, we explored potential associations between gait speed and mortality, incident CVD, and cancer.
DESIGN:
A systematic search in major databases was undertaken from inception until March 15, 2018 for prospective cohort studies reporting data on gait speed and mortality, incident CVD, and cancer.
SETTING AND PARTICIPANTS:
All available.
MEASURES:
The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), based on the model with the maximum number of covariates for each study between gait speed (categorized as decrease in 0.1 m/s) and mortality, incident CVD, and cancer, were meta-analyzed with a random effects model.
RESULTS:
Among 7026 articles, 44 articles corresponding to 48 independent cohorts were eligible. The studies followed up on a total of 101,945 participants (mean age 72.2 years; 55% women) for a median of 5.4 years. After adjusting for a median of 9 potential confounders and the presence of publication bias, each reduction of 0.1 m/s in gait speed was associated with a 14% increased risk of earlier mortality (45 studies; HR = 1.12, 95% CI: 1.09-1.14; I2 = 90%) and 8% increased risk of CVD (13 studies; HR = 1.08, 95% CI: 1.03-1.13; I2 = 81%), but no relationship with cancer was observed (HR = 1.00, 95% CI: 0.97-1.04; I2 = 15%).
CONCLUSION/IMPLICATIONS:
Slow gait speed may be a predictor of mortality and CVD in older adults. Because gait speed is a quick and inexpensive measure to obtain, our study suggests that it should be routinely used and may help identify people at risk of premature mortality and CVD.
Keywords:
Gait speed; cancer; cardiovascular disease; meta-analysis; mortality

Addition of pooled pumpkin seed to mixed meals reduced postprandial glycemia: a randomized placebo-controlled clinical trial.
Cândido FG, de Oliveira FCE, Lima MFC, Pinto CA, da Silva LL, Martino HSD, Dos Santos MH, Alfenas RCG.
Nutr Res. 2018 Aug;56:90-97. doi: 10.1016/j.nutres.2018.04.015. Epub 2018 Apr 26.
PMID: 30055778
https://sci-hub.tw/
Abstract
We investigated if pumpkin and flaxseeds could improve postprandial glycemic, food intake, and appetitive responses. Herein, we hypothesize based on the literature that pumpkin seed has potential to lower postprandial glycemic effects. Therefore, we conducted a randomized, single-blind, placebo-controlled, crossover design study involving normoglycemic adults (food intake: n = 25; glycemia: n = 15). Three high-carbohydrate mixed meals presenting no seed (control [C]) or 65 g of the tested seeds (pumpkin seed [P] or flaxseed [F]) were consumed in 3 nonconsecutive days. Test meals had similar nutritional composition. Blood glucose was measured by capillary finger blood at 0 (immediately before), 15, 30, 45, 60, 90, and 120 minutes after the ingestion of each meal, and the incremental area under glycemic response curves (iAUC) were calculated. Appetitive responses were assessed, and dietary records were used to evaluate food intake on testing days. Glucose iAUC was significantly lower in P compared with C (reduction of ~35%, P = .025). There was no significant differences in glucose iAUC between F and C (P = .257). Glycemic response at each time point did not differ between C, P, and F (Pgroup × time = .238). Fiber consumption was higher in F (P = .009) than in C, but there were no differences in appetitive responses, energy, or macronutrient consumptions between dietary interventions. Acute consumption of 65 g of pumpkin seed markedly reduced postprandial glycemia. Pumpkin seed has potential as a hypoglycemic food, which now deserves to be confirmed in long-term studies.
KEYWORDS:
Appetite; Blood glucose; Body weight; Flaxseed; Food intake; Pumpkin

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APOE Alleles and Extreme Human Longevity.
Sebastiani P, Gurinovich A, Nygaard M, Sasaki T, Sweigart B, Bae H, Andersen SL, Villa F, Atzmon G, Christensen K, Arai Y, Barzilai N, Puca A, Christiansen L, Hirose N, Perls TT.
J Gerontol A Biol Sci Med Sci. 2018 Jul 27. doi: 10.1093/gerona/gly174. [Epub ahead of print]
PMID: 30060062
https://sci-hub.tw/
Abstract
We assembled a collection of 28,297 participants from 7 studies of longevity and healthy aging comprising New England Centenarian, Long Life Family, Longevity Gene Population, Southern Italian Centenarian, Japanese Centenarian, the Danish Longevity and the Health and Retirement Studies to investigate the association between the APOE alleles ɛ2, ɛ3 and ɛ4 and extreme human longevity and age at death. By using 3 different genetic models and two definitions of extreme longevity based on either a threshold model or age at death, we show that ɛ4 is associated with a substantially decreased odds for extreme longevity, and increased risk for death that persists even beyond ages reached by less than 1% of the population. We also show that carrying the ɛ2ɛ3 or ɛ2ɛ3 genotype is associated with significantly increased odds to reach extreme longevity, with decreased risk for death compared to carrying the genotype ɛ2ɛ3 but with only a modest reduction in risk for death beyond an age reached by less than 1% of the population.

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Healthy obesity as an intermediate state of risk: a critical review.
Bell JA, Hamer M.
Expert Rev Endocrinol Metab. 2016 Sep;11(5):403-413. doi: 10.1080/17446651.2016.1220298. Epub 2016 Aug 12.
PMID: 30058911
https://dspace.lboro.ac.uk/dspace-jspui/bitstream/2134/22265/3/Hamer_Healthy_Obesity.pdf
Abstract
Obesity is a top public health priority but interventions to reverse the condition have had limited success. About one-in-three obese adults are free of metabolic risk factor clustering and are considered 'healthy', and much attention has focused on the implications of this state for obesity management. Areas covered: We searched for individual studies, systematic reviews, and meta-analyses which examined correlates and outcomes of metabolically healthy obesity. We discuss the key roles of fat distribution and physical activity in determining healthy vs. unhealthy obesity and report a greatly increased risk of incident type 2 diabetes associated with healthy obesity vs. healthy normal weight, among other outcomes. We argue that despite inconsistencies in the definition, patterns across studies clearly show that healthy obesity is a state of intermediate disease risk. Expert commentary: Given the current state of population-level evidence, we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health. We recommend that weight loss through energy restriction be a stand-alone target in addition to increased physical activity for minimising risk of future disease.
KEYWORDS:
Obesity; body mass index; cardiorespiratory fitness; cardiovascular disease; epidemiology; metabolic health; mortality; physical activity; review; type 2 diabetes

ABO blood group polymorphism has an impact on prostate, kidney and bladder cancer in association with longevity.
Stakišaitis D, Juknevičienė M, Ulys A, Žaliūnienė D, Stanislovaitienė D, Šepetienė R, Slavinska A, Sužiedėlis K, Lesauskaitė V.
Oncol Lett. 2018 Jul;16(1):1321-1331. doi: 10.3892/ol.2018.8749. Epub 2018 May 21.
PMID: 30061952
https://sci-hub.tw/https://www.spandidos-publications.com/10.3892/ol.2018.8749
Abstract
The aim of the present study was to assess the ABO blood group polymorphism association with prostate, bladder and kidney cancer, and longevity. The following data groups were analyzed: Prostate cancer (n=2,200), bladder cancer (n=1,530), renal cell cancer (n=2,650), oldest-old (n=166) and blood donors (n=994) groups. The data on the ABO blood type frequency and odds ratio in prostate cancer patients revealed a significantly higher blood group B frequency (P<0.05); the pooled men and women, separate men bladder cancer risk was significantly associated with the blood group B (P<0.04); however, no such association was identified in the female patients. The blood group O was observed to have a significantly decreased risk of bladder cancer for females (P<0.05). No significance for the ABO blood group type in the studied kidney cancer patients was identified. A comparison of the oldest-old and blood donor groups revealed that blood group A was significantly more frequent and blood type B was significantly rarer in the oldest-olds (P<0.05). The results of the present study indicated that blood type B was associated with the risk of prostate and bladder cancer, and could be evaluated as a determinant in the negative assocation with longevity. Blood types O and A may be positive factors for increasing the oldest-old age likelihood. The clustering analysis by the ABO type frequency demonstrated that the oldest-olds comprised a separate cluster of the studied groups.
KEYWORDS:
ABO blood group; bladder cancer; kidney cancer; longevity; prostate cancer

Alcohol consumption and all-cause mortality in older adults in Spain: an analysis accounting for the main methodological issues.
Ortolá R, García-Esquinas E, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F.
Addiction. 2018 Jul 31. doi: 10.1111/add.14402. [Epub ahead of print]
PMID: 30063272
Abstract
BACKGROUND AND AIMS:
Observational evidence that light-to-moderate alcohol consumption lowers mortality is questioned because of potential selection biases and residual confounding. We assess the association between alcohol intake and all-cause death in older adults after accounting for those methodological issues.
METHODS:
Data came from 3045 individuals representative of the non-institutionalized population aged ≥60 years in Spain. Participants were recruited in 2008-2010, when they reported current and lifetime alcohol intake; drinkers were classified as occasional (<1.43g/day), light (1.43 to <20g/day for men and 1.43 to <10g/day for women), moderate (20 to <40g/day for men and 10 to <20g/day for women) or heavy (≥40g/day for men and ≥24g/day for women)/binge. Participants were followed-up through 2017 to assess vital status. In analyses, ex-drinkers were removed from the abstainer group and were classified according to their lifetime intake to address the "abstainer bias". Moreover, analyses were replicated in individuals without functional limitations, and excluded deaths in the first year of follow-up, to address reverse causation. Also, occasional drinkers were used as reference in some analyses to reduce the "healthy drinker/survivor" bias. Results were adjusted for many covariates to minimize residual confounding.
RESULTS:
Compared with never-drinkers, the hazard ratio (95% confidence interval) of mortality for light drinkers was 1.05 (0.71-1.56) and 1.20 (0.72-2.02) in those without functional limitations. Corresponding values for moderate drinkers were 1.28 (0.81-2.02) and 1.55 (0.87-2.75), and for heavy/binge drinkers 1.85 (1.07-3.23) and 2.15 (1.09-4.22). Results were consistent when occasional drinkers were used as reference. Among drinkers without functional limitations, the hazard ratio (95% confidence interval) of mortality per 10g/day of alcohol was 1.12 (1.02-1.23).
CONCLUSION:
After accounting for potential biases, light-to-moderate drinking among people 60+ years of age appears to have no statistically significant benefit on mortality compared with abstention from alcohol. By contrast, heavy/binge drinking shows higher death risk compared with abstention from alcohol. Alcohol intake appears to have a positive dose-response with mortality among drinkers.
KEYWORDS:
alcohol; mortality; older adults; selection bias

Low Concentrations of Caffeine and Its Analogs Extend the Lifespan of Caenorhabditis elegans by Modulating IGF-1-Like Pathway.
Du X, Guan Y, Huang Q, Lv M, He X, Yan L, Hayashi S, Fang C, Wang X, Sheng J.
Front Aging Neurosci. 2018 Jul 16;10:211. doi: 10.3389/fnagi.2018.00211. eCollection 2018.
PMID: 30061824
Abstract
Caffeine has been reported to delay aging and protect aging-associated disorders in Caenorhabditis elegans. However, the effects of low concentration of caffeine and its analogs on lifespan are currently missing. Herein, we report that at much lower concentrations (as low as 10 μg/ml), caffeine extended the lifespan of C. elegans without affecting food intake and reproduction. The effect of caffeine was dependent on IGF-1-like pathway, although the insulin receptor homolog, daf-2 allele, e1371, was dispensable. Four caffeine analogs, 1-methylxanthine, 7-methylxanthine, 1,3-dimethylxanthine, and 1,7-dimethylxanthine, also extended lifespan, whereas 3-methylxanthine and 3,7-dimethylxanthine did not exhibit lifespan-extending activity.
KEYWORDS:
C. elegans; IGF-1 pathway; caffeine; daf-2; lifespan

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Coffee consumption and mortality from all causes of death, cardiovascular disease and cancer in an elderly Spanish population.
Torres-Collado L, Garcia-de-la-Hera M, Navarrete-Muñoz EM, Notario-Barandiaran L, Gonzalez-Palacios S, Zurriaga O, Melchor I, Vioque J.
Eur J Nutr. 2018 Jul 31. doi: 10.1007/s00394-018-1796-9. [Epub ahead of print]
PMID: 30066178
Abstract
PURPOSE:
The effect of coffee consumption on mortality has been scarcely investigated in the elderly. We assessed the association between coffee consumption and mortality from all-cause, cardiovascular disease (CVD) and cancer, in an elderly population of Spain.
METHODS:
We studied 903 individuals (511 women) aged 65 years and older from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey. Coffee consumption and diet were assessed using a validated food frequency questionnaire. Information on education, anthropometry, sleeping time, smoking, alcohol intake, physical activity and pre-existing disease was collected at baseline. Deaths were ascertained during a 12-year follow-up period, and Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HR).
RESULTS:
There were 403 deaths during the 12-year period (40% from CVD), 174 of which occurred during the first 6 years. We observed evidence of a lower CVD mortality among coffee drinkers in the first 6 years of follow-up. Drinkers of ≤1 cup of coffee/day and > 1 cup/day showed lower CVD mortality than non-drinkers of coffee, HR 0.82 (95% CI 0.46-1.44) and HR 0.38 (0.15-0.96), respectively (p trend = 0.04). This association of coffee with CVD mortality attenuated after 12 years of follow-up. No significant association was observed with all-cause or cancer mortality, neither for caffeinated and decaffeinated coffee.
CONCLUSIONS:
In this study, coffee consumption was associated with lower CVD mortality in elderly. Although this association should be further investigated, coffee consumption appears to be safe for the elderly since no increased mortality was observed in coffee drinkers.
KEYWORDS:
Caffeinated; Cardiovascular mortality.; Coffee; Decaffeinated; Elderly; Mortality

Metabolic and lifestyle risk factors for acute pancreatitis in Chinese adults: A prospective cohort study of 0.5 million people.
Pang Y, Kartsonaki C, Turnbull I, Guo Y, Yang L, Bian Z, Chen Y, Millwood IY, Bragg F, Gong W, Xu Q, Kang Q, Chen J, Li L, Holmes MV, Chen Z.
PLoS Med. 2018 Aug 1;15(8):e1002618. doi: 10.1371/journal.pmed.1002618. eCollection 2018 Aug.
PMID: 30067849
Abstract
BACKGROUND:
Little prospective evidence exists about risk factors and prognosis of acute pancreatitis in China. We examined the associations of certain metabolic and lifestyle factors with risk of acute pancreatitis in Chinese adults.
METHODS AND FINDINGS:
The prospective China Kadoorie Biobank (CKB) recruited 512,891 adults aged 30 to 79 years from 5 urban and 5 rural areas between 25 June 2004 and 15 July 2008. During 9.2 years of follow-up (to 1 January 2015), 1,079 cases of acute pancreatitis were recorded. Cox regression was used to estimate adjusted hazard ratios (HRs) for acute pancreatitis associated with various metabolic and lifestyle factors among all or male (for smoking and alcohol drinking) participants. Overall, the mean waist circumference (WC) was 82.1 cm (SD 9.8) cm in men and 79.0 cm (SD 9.5) cm in women, 6% had diabetes, and 6% had gallbladder disease at baseline. WC was positively associated with risk of acute pancreatitis, with an adjusted HR of 1.35 (95% CI 1.27-1.43; p < 0.001) per 1-SD-higher WC. Individuals with diabetes or gallbladder disease had HRs of 1.34 (1.07-1.69; p = 0.01) and 2.42 (2.03-2.88; p < 0.001), respectively. Physical activity was inversely associated with risk of acute pancreatitis, with each 4 metabolic equivalent of task (MET) hours per day (MET-h/day) higher physical activity associated with an adjusted HR of 0.95 (0.91-0.99; p = 0.03). Compared with those without any metabolic risk factors (i.e., obesity, diabetes, gallbladder disease, and physical inactivity), the HRs of acute pancreatitis for those with 1, 2, or ≥3 risk factors were 1.61 (1.47-1.76), 2.36 (2.01-2.78), and 3.41 (2.46-4.72), respectively (p < 0.001). Among men, heavy alcohol drinkers (≥420 g/week) had an HR of 1.52 (1.11-2.09; p = 0.04, compared with abstainers), and current regular smokers had an HR of 1.45 (1.28-1.64; p = 0.02, compared with never smokers). Following a diagnosis of acute pancreatitis, there were higher risks of pancreatic cancer (HR = 8.26 [3.42-19.98]; p < 0.001; 13 pancreatic cancer cases) and death (1.53 [1.17-2.01]; p = 0.002; 89 deaths). Other diseases of the pancreas had similar risk factor profiles and prognosis to acute pancreatitis. The main study limitations are ascertainment of pancreatitis using hospital records and residual confounding.
CONCLUSIONS:
In this relatively lean Chinese population, several modifiable metabolic and lifestyle factors were associated with higher risks of acute pancreatitis, and individuals with acute pancreatitis had higher risks of pancreatic cancer and death.


Metabolic and lifestyle risk factors for acute pancreatitis in Chinese adults: A prospective cohort study of 0.5 million people.
Pang Y, Kartsonaki C, Turnbull I, Guo Y, Yang L, Bian Z, Chen Y, Millwood IY, Bragg F, Gong W, Xu Q, Kang Q, Chen J, Li L, Holmes MV, Chen Z.
PLoS Med. 2018 Aug 1;15(8):e1002618. doi: 10.1371/journal.pmed.1002618. eCollection 2018 Aug.
PMID: 30067849
Abstract
BACKGROUND:
Little prospective evidence exists about risk factors and prognosis of acute pancreatitis in China. We examined the associations of certain metabolic and lifestyle factors with risk of acute pancreatitis in Chinese adults.
METHODS AND FINDINGS:
The prospective China Kadoorie Biobank (CKB) recruited 512,891 adults aged 30 to 79 years from 5 urban and 5 rural areas between 25 June 2004 and 15 July 2008. During 9.2 years of follow-up (to 1 January 2015), 1,079 cases of acute pancreatitis were recorded. Cox regression was used to estimate adjusted hazard ratios (HRs) for acute pancreatitis associated with various metabolic and lifestyle factors among all or male (for smoking and alcohol drinking) participants. Overall, the mean waist circumference (WC) was 82.1 cm (SD 9.8) cm in men and 79.0 cm (SD 9.5) cm in women, 6% had diabetes, and 6% had gallbladder disease at baseline. WC was positively associated with risk of acute pancreatitis, with an adjusted HR of 1.35 (95% CI 1.27-1.43; p < 0.001) per 1-SD-higher WC. Individuals with diabetes or gallbladder disease had HRs of 1.34 (1.07-1.69; p = 0.01) and 2.42 (2.03-2.88; p < 0.001), respectively. Physical activity was inversely associated with risk of acute pancreatitis, with each 4 metabolic equivalent of task (MET) hours per day (MET-h/day) higher physical activity associated with an adjusted HR of 0.95 (0.91-0.99; p = 0.03). Compared with those without any metabolic risk factors (i.e., obesity, diabetes, gallbladder disease, and physical inactivity), the HRs of acute pancreatitis for those with 1, 2, or ≥3 risk factors were 1.61 (1.47-1.76), 2.36 (2.01-2.78), and 3.41 (2.46-4.72), respectively (p < 0.001). Among men, heavy alcohol drinkers (≥420 g/week) had an HR of 1.52 (1.11-2.09; p = 0.04, compared with abstainers), and current regular smokers had an HR of 1.45 (1.28-1.64; p = 0.02, compared with never smokers). Following a diagnosis of acute pancreatitis, there were higher risks of pancreatic cancer (HR = 8.26 [3.42-19.98]; p < 0.001; 13 pancreatic cancer cases) and death (1.53 [1.17-2.01]; p = 0.002; 89 deaths). Other diseases of the pancreas had similar risk factor profiles and prognosis to acute pancreatitis. The main study limitations are ascertainment of pancreatitis using hospital records and residual confounding.
CONCLUSIONS:
In this relatively lean Chinese population, several modifiable metabolic and lifestyle factors were associated with higher risks of acute pancreatitis, and individuals with acute pancreatitis had higher risks of pancreatic cancer and death.

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