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Moderate Dietary Protein Restriction Optimized Gut Microbiota and Mucosal Barrier in Growing Pig Model.
Chen X, Song P, Fan P, He T, Jacobs D, Levesque CL, Johnston LJ, Ji L, Ma N, Chen Y, Zhang J, Zhao J, Ma X.
Front Cell Infect Microbiol. 2018 Jul 18;8:246. doi: 10.3389/fcimb.2018.00246. eCollection 2018.
PMID: 30073151
https://www.frontiersin.org/articles/10.3389/fcimb.2018.00246/full
Abstract
Appropriate protein concentration is essential for animal at certain stage. This study evaluated the effects of different percentages of dietary protein restriction on intestinal health of growing pigs. Eighteen barrows were randomly assigned to a normal (18%), low (15%), and extremely low (12%) dietary protein concentration group for 30 days. Intestinal morphology and permeability, bacterial communities, expressions, and distributions of intestinal tight junction proteins, expressions of biomarkers of intestinal stem cells (ISCs) and chymous bacterial metabolites in ileum and colon were detected. The richness and diversity of bacterial community analysis with Chao and Shannon index were highest in the ileum of the 15% crude protein (CP) group. Ileal abundances of Streptococcaceae and Enterobacteriaceae decreased respectively, while beneficial Lactobacillaceae, Clostridiaceae_1, Actinomycetaceae, and Micrococcaceae increased their proportions with a protein reduction of 3 percentage points. Colonic abundances of Ruminococcaceae, Christensenellaceae, Clostridiaceae_1, Spirochaetaceae, and Bacterodales_S24-7_group declined respectively, while proportions of Lachnospiraceae, Prevotellaceae, and Veillonellaceae increased with dietary protein reduction. Concentrations of most bacterial metabolites decreased with decreasing dietary protein concentration. Ileal barrier function reflected by expressions of tight junction proteins (occludin, zo-3, claudin-3, and claudin-7) did not show significant decrease in the 15% CP group while sharply reduced in the 12% CP group compared to that in the 18% CP group. And in the 15% CP group, ileal distribution of claudin-3 mainly located in the cell membrane with complete morphological structure. In low-protein treatments, developments of intestinal villi and crypts were insufficient. The intestinal permeability reflected by serous lipopolysaccharide (LPS) kept stable in the 15% CP group while increased significantly in the 12% CP group. The expression of ISCs marked by Lgr5 slightly increased in ileum of the 15% CP group. Colonic expressions of tight junction proteins declined in extremely low protein levels. In conclusion, moderate protein restriction (15% CP) can optimize the ileal microbiota structure via strengthening beneficial microbial populations and suppressing harmful bacterial growth and altering the function of ileal tight junction proteins as well as epithelial cell proliferation.
KEYWORDS:
dietary protein restriction; growing pigs; intestinal microbiota; intestinal stem cell; mucosal barrier

Omega-3 fatty acids decrease prostate cancer progression associated with an anti-tumor immune response in eugonadal and castrated mice.
Gevariya N, Besançon M, Robitaille K, Picard V, Diabaté L, Alesawi A, Julien P, Fradet Y, Bergeron A, Fradet V.
Prostate. 2018 Aug 2. doi: 10.1002/pros.23706. [Epub ahead of print]
PMID: 30073695
Abstract
BACKGROUND:
Several lines of evidence suggest effects of dietary fat on prostate cancer (PCa) development and progression. Targeting omega (ω)-3:ω6 fatty acids (FA) ratio could be beneficial against PCa by favorably modulating inflammation. Here, we studied the effects of ω3- and ω6-enriched diets on prostate tumor growth and inflammatory response in androgen-deprived and non-deprived conditions.
METHODS:
Immune-competent eugonadal and castrated C57BL/6 mice were injected with TRAMP-C2 prostate tumor cells and daily fed with ω3- or ω6-enriched diet. FA and cytokine profiles were measured in blood and tumors using gas chromatography and multiplex immunoassay, respectively. Immune cell infiltration in tumors was profiled by multicolor flow cytometry.
RESULTS:
ω3-enriched diet decreased prostate TRAMP-C2 tumor growth in immune-competent eugonadal and castrated mice. Cytokines associated with Th1 immune response (IL-12 [p70], IFN-γ, GM-CSF) and eosinophil recruitment (eotaxin-1, IL-5, and IL-13) were significantly elevated in tumors of ω3-fed mice. Using in vitro experiments, we confirmed ω3 FA-induced eotaxin-1 secretion by tumor cells and that eotaxin-1 secretion was regulated by androgens. Analysis of immune cell infiltrating tumors showed no major difference of immune cells' abundance between ω3- and ω6-enriched diets.
CONCLUSIONS:
ω3-enriched diet reduces prostate tumor growth independently of androgen levels. ω3 FA can inhibit tumor cell growth and induce a local anti-tumor inflammatory response. These findings warrant further examination of dietary ω3's potential to slow down the progression of androgen-sensitive and castrate-resistant PCa by modulating immune cell function in tumors.
KEYWORDS:
TRAMP-C2; androgens; cytokines; eotaxin-1; inflammation

Gluten intake and risk of type 2 diabetes in three large prospective cohort studies of US men and women.
Zong G, Lebwohl B, Hu FB, Sampson L, Dougherty LW, Willett WC, Chan AT, Sun Q.
Diabetologia. 2018 Aug 3. doi: 10.1007/s00125-018-4697-9. [Epub ahead of print]
PMID: 30074058
https://sci-hub.tw/10.1007/s00125-018-4697-9
Abstract
AIMS/HYPOTHESIS:
We investigated the association between gluten intake and long-term type 2 diabetes risk among Americans.
METHODS:
We followed women from the Nurses' Health Study (NHS, n = 71,602, 1984-2012) and NHS II (n = 88,604, 1991-2013) and men from the Health Professionals Follow-Up Study (HPFS, n = 41,908, 1986-2012). Gluten intake was estimated using a validated food frequency questionnaire every 2-4 years. Incident type 2 diabetes was defined as self-reported physician-diagnosed diabetes confirmed using a supplementary questionnaire.
RESULT:
Gluten intake was strongly correlated with intakes of carbohydrate components, especially refined grains, starch and cereal fibre (Spearman correlation coefficients >0.6). During 4.24 million years of follow-up, 15,947 people were confirmed to have type 2 diabetes. After multivariate adjustment, pooled HRs and 95% CIs for type 2 diabetes, from low to high gluten quintiles, were (ptrend < 0.001): 1 (reference); 0.89 (0.85, 0.93); 0.84 (0.80, 0.88); 0.78 (0.74, 0.82) and 0.80 (0.76, 0.84). The association was slightly weakened after further adjusting for cereal fibre, with pooled HRs (95% CIs) of (ptrend < 0.001): 1 (reference); 0.91 (0.87, 0.96); 0.88 (0.83, 0.93); 0.83 (0.78, 0.88) and 0.87 (0.81, 0.93). Dose-response analysis supported a largely linear inverse relationship between gluten intake up to 12 g/day and type 2 diabetes. The association between gluten intake and type 2 diabetes was stronger when intake of added bran was also higher (pinteraction = 0.02).
CONCLUSIONS/INTERPRETATION:
Gluten intake is inversely associated with type 2 diabetes risk among largely healthy US men and women. Limiting gluten in the diet is associated with lower intake of cereal fibre and possibly other beneficial nutrients that contribute to good health.
KEYWORDS:
Gluten; Type 2 diabetes

Associations of coffee, tea and caffeine intake with risk of breast, endometrial and ovarian cancer among Canadian women.
Arthur R, Kirsh VA, Rohan TE.
Cancer Epidemiol. 2018 Jul 31;56:75-82. doi: 10.1016/j.canep.2018.07.013. [Epub ahead of print]
PMID: 30075330
https://sci-hub.tw/10.1016/j.canep.2018.07.013
Abstract
BACKGROUND:
Although, biologically plausible evidence has implicated coffee, tea and caffeine with carcinogenesis, there is a paucity of data on their associations with risk of cancer among Canadian women. Hence, we assessed their associations with risk of breast, endometrial and ovarian cancers within this population.
METHODS:
The study comprised a subcohort of 3185 women from a cohort of 39,532 female participants who completed self-administered lifestyle and dietary questionnaires at enrollment. During a median follow-up of approximately 12.2years, we ascertained 922, 180 and 104 breast, endometrial and ovarian cancer cases, respectively. We used Cox proportional hazards regression models modified for the case-cohort design to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the associations of coffee, tea and caffeine with risk of selected cancers.
RESULTS:
Coffee, tea, and caffeine intake were not associated with overall risk of breast and ovarian cancers. There was, however, a tendency towards an increased risk of breast cancer with increasing levels of total coffee, caffeinated coffee and/or caffeine among premenopausal and normal weight women. Total coffee, caffeinated coffee, and caffeine were inversely associated with risk of endometrial cancer (HRper cup increase: 0.88; 95% CI: 0.79-0.95, HRper cup increase: 0.88; 95% CI: 0.80-0.96 and HRper 100mg increase: 0.93; 95% CI: 0.87-0.99, respectively).
CONCLUSION:
Our findings suggest that coffee and/or caffeine may be associated with reduced risk of endometrial cancer but, probably, associated increased with risk of breast cancer among premenopausal or normal weight women. However, further studies are needed to confirm our findings.
KEYWORDS:
Breast cancer; Caffeine; Coffee; Endometrial cancer; Ovarian cancer; Tea

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Dietary Salt Intake is a Significant Determinant of Impaired Kidney Function in the General Population.
Sugiura T, Takase H, Ohte N, Dohi Y.
Kidney Blood Press Res. 2018 Aug 3;43(4):1245-1254. doi: 10.1159/000492406. [Epub ahead of print]
PMID: 30078009
https://www.karger.com/Article/Pdf/492406
bstract
BACKGROUND/AIMS:
Kidney dysfunction is an important risk factor for cardiovascular disease and end-stage renal disease. This study investigated whether dietary salt intake predicts deterioration of kidney function in the general population.
METHODS:
In all, 12 126 subjects with a normal estimated glomerular filtration rate (eGFR ≥60 mL/min per 1.73m2) attending an annual check-up were enrolled in the study and were followed-up for a median of 1754 days; the endpoint was the development of impaired kidney function (eGFR < 60 mL/min per 1.73m2). Individual salt intake was estimated using spot urine analysis.
RESULTS:
At baseline, mean (± SD) salt intake and eGFR were 10.6 ± 3.4 g/day and 80.8 ± 12.9 mL/min per 1.73m2, respectively. During the follow-up period, 1384 subjects (25.2 per 1000 person-years) developed impaired kidney function. Multivariate Cox hazard regression analysis revealed salt intake as a significant predictor of the new onset of kidney impairment (hazard ratio 1.045; 95% confidence interval 1.025-1.065). Subjects were divided into two groups based on salt intake; the incidence of impaired kidney function was higher in the group with high than low salt intake (P < 0.001, log-rank test). Multivariate Cox hazard regression analysis indicated a 29% increased risk of developing impaired kidney function in the high-salt group. Multivariate linear regression analysis showed a significant correlation between salt intake and yearly decline in eGFR (β = 0.060, P < 0.001).
CONCLUSION:
Salt intake is associated with the development of impaired kidney function in the general population, independent of its effects on blood pressure. Salt restriction may help prevent the development of impaired kidney function.
KEYWORDS:
Chronic kidney disease; Estimated glomerular filtration rate; Impaired kidney function; Salt intake

Baseline and longitudinal change in blood pressure and mortality in a Chinese cohort.
Wang JB, Huang QC, Hu SC, Zheng PW, Shen P, Li D, Lu HC, Gao X, Lin HB, Chen K.
J Epidemiol Community Health. 2018 Aug 4. pii: jech-2018-211050. doi: 10.1136/jech-2018-211050. [Epub ahead of print]
PMID: 30077965
https://sci-hub.tw/10.1136/jech-2018-211050
Abstract
BACKGROUND:
A J-curve association has been demonstrated for blood pressure (BP) and all-cause mortality, but data on longitudinal change of BP and mortality in Chinese population are limited.
METHODS:
We performed a retrospective cohort study to examine the association between BP (at baseline and longitudinal change) and risk of mortality in Yinzhou District, Ningbo, China, based on the Yinzhou Health Information System. At baseline, a total of 181 352 subjects aged over 18 years with at least one BP examination record were recruited through the Yinzhou Health Information System. The final analysis was restricted to 168 061 participants after exclusion of outliers of BP.
RESULTS:
A U-shaped association was observed for BP at baseline and risk of total and cardiovascular mortality. When compared with normotensive participants, patients with hypotension (HRs=1.51, 95% CI 1.21 to 1.88) and stage 3 hypertension (1.28, 95% CI 1.09 to 1.50) had an increased risk of all-cause mortality. Relative to stable BP of normotension, having a rise in BP from normotension to hypertension or from prehypertension to hypertension both conferred an increased risk of total and cardiovascular mortality (total: 1.39 (95% 1.10 to 1.75) and 1.40 (95% 1.15 to 1.69); cardiovascular: 2.22 (95% CI 1.35 to 3.65) and 1.89 (95% CI 1.20 to 2.96), respectively).
CONCLUSIONS:
Our findings emphasise that hypotension and stage 3 hypertension were associated with an increased risk of all-cause mortality. Longitudinal change from normotensive or prehypertensive levels to 140/90 mm Hg or higher could increase the risk of total and cardiovascular mortality.
KEYWORDS:
blood pressure; cardiovascular disease; cohort studies; stroke

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Short-term time-restricted feeding during the resting phase is sufficient to induce leptin resistance that contributes to development of obesity and metabolic disorders in mice.
Oishi K, Hashimoto C.
Chronobiol Int. 2018 Aug 7:1-19. doi: 10.1080/07420528.2018.1496927. [Epub ahead of print]
PMID: 30084652
Abstract
Feeding at unusual times of the day is thought to be associated with obesity and metabolic disorders in both experimental animals and humans. We previously reported that time-imposed feeding during the sleep phase (daytime feeding, DF) induces obesity and metabolic disorders compared with mice fed only during the active phase (nighttime feeding, NF). The present study aimed to determine whether leptin resistance is caused by DF, and whether it is involved in the underlying mechanisms of DF-induced obesity in mice, since leptin plays an essential role in regulating energy expenditure and adiposity in addition to food intake. We compared leptin sensitivity by evaluating the effects of exogenous injected leptin on food intake and body weight in wild-type C57BL/6J mice under NF and DF. The mice were fed with a high-fat high-sucrose diet throughout the study. To determine whether leptin resistance is a cause or a result of DF-induced obesity with metabolic disorders, we restricted the feeding times of leptin resistant db/db mice. We also examined leptin sensitivity in leptin deficient ob/ob mice under NF and DF to elucidate the underlying mechanisms of DF-induced leptin resistance. C57BL/6J mice under DF gained more weight and adiposity compared with mice under NF, and developed hyperleptinemia and hypothermia. We found that six days of DF abolished exogenous leptin-induced hypophagia and reduction in body weight in mice. We also found that the leptin injection significantly suppressed the mRNA expression of lipogenic genes in the liver of NF, but not in DF mice, suggesting that short-term DF was sufficient to induce metabolic leptin resistance. The DF-induced increases in body weight gain, food efficiency, adipose tissue mass, lipogenic gene expression in metabolic tissues, and hepatic lipid accumulation were abolished in db/db mice, suggesting that the leptin resistance is a cause of DF-induced metabolic disorders. DF resulted in deep hypothermia in db/db, as well as in wild-type mice, suggesting that a decrease in energy expenditure was not the main cause of DF-induced obesity. Exogenous leptin reduced the body weight of ob/ob mice under both NF and DF, and the effect was significantly higher in DF- than in NF-ob/ob mice. Therefore, the development of DF-induced leptin resistance requires endogenous leptin, and central leptin sensitivity fluctuates in a circadian manner. The present findings suggest that leptin resistance is responsible for DF-induced obesity and metabolic disorders, and that the circadian fluctuation of central leptin sensitivity might be involved in leptin resistance induced by DF, although further studies are needed to elucidate the mechanisms of metabolic disorders that depend on the time of feeding.
ABBREVIATIONS:
AMPK, adenosine monophosphate-activated protein kinase; ANOVA, analysis of variance; DF, daytime feeding; FFA, free fatty acid; HOMA-IR, homeostasis model assessment of insulin resistance; NEAT, non-exercise activity thermogenesis; NF, nighttime feeding; PI3, phosphatidylinositol 3; RF, restricted feeding; RW, running-wheel; SCN, suprachiasmatic nucleus; SEM, standard error of the mean; STAT3, signal transducer and activator of transcription 3; T-Cho, total cholesterol; TG, triglyceride; WAT, white adipose tissues.
KEYWORDS:
Circadian clock; Feeding rhythm; Leptin; Lipogenesis; Obesity

Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth.
Olsen SF, Halldorsson TI, Thorne-Lyman AL, Strøm M, Gørtz S, Granstrøm C, Nielsen PH, Wohlfahrt J, Lykke JA, Langhoff-Roos J, Cohen AS, Furtado JD, Giovannucci EL, Zhou W.
EBioMedicine. 2018 Aug 2. pii: S2352-3964(18)30252-4. doi: 10.1016/j.ebiom.2018.07.009. [Epub ahead of print]
PMID: 30082226
https://www.ebiomedicine.com/article/S2352-3964(18)30252-4/fulltext
Abstract
BACKGROUND:
Fish oil supplementation has been shown to delay spontaneous delivery, but the levels and clinical significance remain uncertain. We examined the association between plasma fatty acids quantified in pregnancy and subsequent risk of early preterm birth.
METHODS:
In a case-control design nested in the Danish National Birth Cohort, we identified 376 early preterm cases (<34 gestational weeks, excluding preeclampsia cases) and 348 random controls. Plasma eicosapentaenoic acid plus docosahexaenoic acid (EPA+DHA% of total fatty acids), were measured twice in pregnancy, at gestation weeks 9 and 25 (medians). Odds ratios and 95% confidence intervals (CI's) for associations between EPA+DHA and early preterm risk were estimated by logistic regression, adjusted for the woman's age, height, pre-pregnancy BMI, parity, smoking, and socioeconomic factors. Hypotheses and analytical plan were defined and archived a priori.
FINDINGS:
Analysis using restricted cubic splines of the mean of 1st and 2nd sample measurements showed a strong and significant non-linear association (p < 0.0001) in which the risk of early preterm birth steeply increased when EPA+DHA concentrations were lower than 2% and flattened out at higher levels. Women in the lowest quintile (EPA+DHA < 1.6%) had 10.27 times (95% confidence interval 6.80-15.79, p < 0.0001) increased risk, and women in the second lowest quintile had 2.86 (95% CI 1.79-4.59, p < 0.0001) times increased risk, when compared to women in the three aggregated highest quintiles (EPA+DHA ≥ 1.8%).
INTERPRETATION:
Low plasma concentration of EPA and DHA during pregnancy is a strong risk factor for subsequent early preterm birth in Danish women.
KEYWORDS:
Biomarkers; Danish National Birth Cohort; Early preterm birth; Long chained n-3 fatty acids; Prospective study

Effects of Multivitamin and Multimineral Supplementation on Blood Pressure: A Meta-Analysis of 12 Randomized Controlled Trials.
Li K, Liu C, Kuang X, Deng Q, Zhao F, Li D.
Nutrients. 2018 Aug 3;10(8). pii: E1018. doi: 10.3390/nu10081018.
PMID: 30081527
http://www.mdpi.com/2072-6643/10/8/1018/htm
Abstract
Previous studies have not drawn a consistent conclusion about effect of multivitamin and multimineral supplementation (MVMS) on blood pressure. A comprehensive search of PubMed, Embase and Cochrane Library (up to May 2018) and references of relevant articles was undertaken. The present meta-analysis included 12 randomized controlled trials (RCTs), of which eight RCTs in 2011 subjects evaluated the effect of MVMS on blood pressure and four RCTs in 21,196 subjects evaluated the effect of MVMS on the risk of hypertension. MVMS had a lowering effect on systolic blood pressure (SBP) and diastolic blood pressure (DBP): the weighted mean difference (WMD) was -1.31 mmHg (95% CI, -2.48 to -0.14 mmHg) and -0.71 mmHg (95% CI, -1.43 to 0.00 mmHg), respectively. Subgroup analysis indicated that the lowering effect of MVMS on blood pressure was only significant in 134 subjects with chronic disease but not in 1580 healthy subjects, and the WMD for systolic blood pressure (SBP) and DBP in subjects with chronic disease was -6.29 mmHg (95% CI, -11.09 to -1.50 mmHg) and -2.32 mmHg (95% CI, -4.50 to -0.13 mmHg), respectively. The effect size of MVMS on SBP in 58 hypertensive subjects (WMD, -7.98 mmHg; 95% CI, -14.95 to -1.02 mmHg) was more than six times of that in 1656 normotensive subjects (WMD, -1.25 mmHg; 95% CI, -2.48 to -0.02 mmHg). However, no significant effect on DBP was observed in both hypertensive and normotensive subgroups. There was no significant effect of MVMS on risk of hypertension in 22,852 subjects with a normal blood pressure at baseline. In conclusion, although MVMS had a significant lowering effect on blood pressure in normotensive subjects, the lowering effect was too small to effectively prevent future hypertension. MVMS may be an effective method for blood pressure control in subjects with chronic disease including hypertension, but the sample size of subjects with hypertension or other chronic disease was too small, and more well-designed RCTs are needed to confirm this result.
KEYWORDS:
blood pressure; hypertension; meta-analysis; multiminerals; multivitamins

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Short-term feeding of a ketogenic diet induces more severe hepatic insulin resistance than a obesogenic high-fat diet.
Grandl G, Straub L, Rudigier C, Arnold M, Wueest S, Konrad D, Wolfrum C.
J Physiol. 2018 Aug 8. doi: 10.1113/JP275173. [Epub ahead of print]
PMID: 30089335
Abstract
KEY POINTS:
A ketogenic diet is known to lead to weight loss and is considered metabolically healthy; however there are conflicting reports on its effect on hepatic insulin sensitivity. KD fed animals appear metabolically healthy in the fasted state after 3 days of dietary challenge, whereas obesogenic high-fat diet (HFD) fed animals show elevated insulin levels. A glucose challenge reveals that both KD and HFD fed animals are glucose intolerant. Glucose intolerance correlates with increased lipid oxidation and lower respiratory exchange ratio (RER); however, all animals respond to glucose injection with an increase in RER. Hyperinsulinaemic-euglycaemic clamps with double tracer show that the effect of KD is a result of hepatic insulin resistance and increased glucose output but not impaired glucose clearance or tissue glucose uptake in other tissues.
ABSTRACT:
Despite being a relevant healthcare issue and heavily investigated, the aetiology of type 2 diabetes (T2D) is still incompletely understood. It is well established that increased endogenous glucose production (EGP) leads to a progressive increase in glucose levels, causing insulin resistance and eventual loss of glucose homeostasis. The consumption of high carbohydrate, high-fat, western style diet (HFD) is linked to the development of T2D and obesity, whereas the consumption of a low carbohydrate, high-fat, ketogenic diet (KD) is considered healthy. However, several days of carbohydrate restriction are known to cause selective hepatic insulin resistance. In the present study, we compare the effects of short-term HFD and KD feeding on glucose homeostasis in mice. We show that, even though KD fed animals appear to be healthy in the fasted state, they exhibit decreased glucose tolerance to a greater extent than HFD fed animals. Furthermore, we show that this effect originates from blunted suppression of hepatic glucose production by insulin, rather than impaired glucose clearance and tissue glucose uptake. These data suggest that the early effects of HFD consumption on EGP may be part of a normal physiological response to increased lipid intake and oxidation, and that systemic insulin resistance results from the addition of dietary glucose to EGP-derived glucose.
KEYWORDS:
high fat diet; insulin resistance; ketogenic diet

Cumin (Cuminum cyminum L.) is a safe approach for management of lipid parameters: A systematic review and meta-analysis of randomized controlled trials.
Hadi A, Mohammadi H, Hadi Z, Roshanravan N, Kafeshani M.
Phytother Res. 2018 Aug 8. doi: 10.1002/ptr.6162. [Epub ahead of print] Review.
PMID: 30088304
Abstract
We performed a meta-analysis to evaluate the efficacy of cumin supplementation on plasma lipid concentration in adult population. The search included PubMed, Scopus, ISI Web of Science, Google Scholar, and the Cochrane library (up to January 2018) to identify randomized controlled trials (RCTs) investigating the effects of cumin supplementation on serum lipid parameters. Mean difference (MD) was pooled using a random-effects model. Meta-analysis of data from six eligible RCTs with 376 participants showed a significant reduction in plasma concentration of total cholesterol (MD [95% CI] -10.90 [-21.39, -0.42] mg/dl, p = 0.042) and low-density lipoprotein cholesterol (MD [95% CI] -6.94 [-11.53, -2.35] mg/dl, p = 0.003) after supplementation with cumin compared with control treatment, and plasma concentration of high-density lipoprotein cholesterol (MD [95% CI] 3.35 [1.58, 5.12] mg/dl, p˂0.001) were found to be increased. Although our analysis indicated that cumin supplementation cannot change triglyceride (TG) concentration (MD [95% CI] -20.48 [-41.23, -0.26] mg/dl, p = 0.053), but after stratified the RCTs based on the primary level of TG (hypertriglyceridemia versus nonhypertriglyceridemia subjects), there was a significant decrease in nonhypertriglyceridemia subset. This systematic review and meta-analysis suggested the efficacy of cumin supplementation on lipid parameters.
KEYWORDS:
cumin; lipids; meta-analysis; randomized controlled trials

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Vegetable Protein Intake was Inversely Associated with Cardiovascular Mortality in A 15-Year Follow-Up Study of A General Japanese Population.
Kurihara A, Okamura T, Sugiyama D, Higashiyama A, Watanabe M, Okuda N, Kadota A, Miyagawa N, Fujiyoshi A, Yoshita K, Ohkubo T, Okayama A, Miura K, Ueshima H; NIPPON DATA90 Research Group.
J Atheroscler Thromb. 2018 Aug 9. doi: 10.5551/jat.44172. [Epub ahead of print]
PMID: 30089755
https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_44172/_pdf
Abstract
AIM:
To examine the relationship between the intake of dietary vegetable protein and CVD mortality in a 15-year follow-up study of a representative sample of the Japanese population.
METHODS:
A total of 7,744 participants aged 30 years or older (3,224 males and 4,520 females) who were free of CVD at baseline were included in this analysis. Vegetable protein intake (% energy) was assessed using a three-day semi-weighed dietary record at baseline. Multivariable-adjusted hazard ratios (HRs) were calculated using Cox's proportional hazards model after adjusting for confounding factors.
RESULTS:
The total person-years studied were 107,988 with a mean follow-up period of 13.9 years. There were 1,213 deaths during the follow-up period, among which 354 (29.2%) were due to CVD. Vegetable protein intake was associated inversely with CVD and cerebral hemorrhage mortality, with the HRs for a 1% energy increment in vegetable protein intake being 0.86 (95% CI, 0.75-0.99) and 0.58 (95% CI, 0.35-0.95), respectively. In the subgroup analysis of participants with or without hypertension, the inverse association between vegetable protein intake and CVD mortality was more evident in the nonhypertensive group, with the HRs for CVD and stroke being 0.68 (95% CI, 0.50-0.94) and 0.50 (95% CI, 0.30-0.84), respectively.
CONCLUSIONS:
Vegetable protein intake may prevent future CVD, particularly in nonhypertensive subjects in the Japanese population. However, further studies are necessary to examine the biological mechanisms of this effect.
KEYWORDS:
Cardiovascular disease; Cohort studies; Hypertension; National nutrition survey; Stroke; Vegetable protein

Relationship between Cardiorespiratory Fitness and Non-High-Density Lipoprotein Cholesterol: A Cohort Study.
Watanabe N, S Sawada S, Shimada K, Lee IM, Gando Y, Momma H, Kawakami R, Miyachi M, Hagi Y, Kinugawa C, Okamoto T, Tsukamoto K, N Blair S.
J Atheroscler Thromb. 2018 Aug 8. doi: 10.5551/jat.43851. [Epub ahead of print]
PMID: 30089756
Abstract
AIM:
Recent studies have suggested that non-high-density lipoprotein cholesterol (non-HDL-C) may be a good marker of coronary heart disease and cardiovascular disease risk. Therefore, we investigated the relationship between cardiorespiratory fitness (CRF) and non-HDL-C.
METHODS:
We evaluated CRF and the incidence of high level of non-HDL-C in 4,067 Japanese men without dyslipidemia. The participants were given a submaximal exercise test, a medical examination, and questionnaires on their health habits in 1986. A cycle ergometer was used to measure the CRF and maximal oxygen uptake was estimated. The incidence of a high level of non-HDL -C (≥170 mg/dL) from 1986 to 2006 was ascertained based on the fasting blood levels. A high level of non-HDL-C was found in 1,482 participants during the follow-up. Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of a high level of non-HDL-C.
RESULTS:
Following age adjustment, and using the lowest CRF group (quartile Ⅰ) as reference, the HRs and 95% CIs for quartiles II through IV were: 1.00 (95% CI: 0.87-1.15), 0.87 (95% CI: 0.76-1.00), and 0.70 (95% CI: 0.60-0.81), respectively (P for trend <0.001). After additional adjustment for body mass index, systolic blood pressure, smoking, alcohol intake, and family history of dyslipidemia, the HRs and 95% CIs were: 1.05 (95% CI: 0.92-1.21), 0.94 (95% CI: 0.81-1.08), and 0.79 (95% CI: 0.67-0.92), respectively (P for trend=0.001).
CONCLUSIONS:
These results suggest that there is an inverse relationship between CRF levels and the incidence of a high level of non-HDL-C in Japanese men.
KEYWORDS:
Cholesterol; Cohort study; Epidemiology; Exercise test; Non-high-density lipoprotein cholesterol

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Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE).
Weinmayr G, Pedersen M, Stafoggia M, Andersen ZJ, Galassi C, Munkenast J, Jaensch A, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Rizzuto D, Sørensen M, Tjønneland A, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Concin H, Lang A, Wang M, Tsai MY, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, de Hoogh K, Beelen R, Vineis P, Kooter I, Sokhi R, Brunekreef B, Hoek G, Raaschou-Nielsen O, Nagel G.
Environ Int. 2018 Aug 7;120:163-171. doi: 10.1016/j.envint.2018.07.030. [Epub ahead of print]
PMID: 30096610
Abstract
INTRODUCTION:
Previous analysis from the large European multicentre ESCAPE study showed an association of ambient particulate matter <2.5 μm (PM2.5) air pollution exposure at residence with the incidence of gastric cancer. It is unclear which components of PM are most relevant for gastric and also upper aerodigestive tract (UADT) cancer and some of them may not be strongly correlated with PM mass. We evaluated the association between long-term exposure to elemental components of PM2.5 and PM10 and gastric and UADT cancer incidence in European adults.
METHODS:
Baseline addresses of individuals were geocoded and exposure was assessed by land-use regression models for copper (Cu), iron (Fe) and zinc (Zn) representing non-tailpipe traffic emissions; sulphur (S) indicating long-range transport; nickel (Ni) and vanadium (V) for mixed oil-burning and industry; silicon (Si) for crustal material and potassium (K) for biomass burning. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses.
RESULTS:
Ten cohorts in six countries contributed data on 227,044 individuals with an average follow-up of 14.9 years with 633 incident cases of gastric cancer and 763 of UADT cancer. The combined hazard ratio (HR) for an increase of 200 ng/m3 of PM2.5_S was 1.92 (95%-confidence interval (95%-CI) 1.13;3.27) for gastric cancer, with no indication of heterogeneity between cohorts (I2 = 0%), and 1.63 (95%-CI 0.88;3.01) for PM2.5_Zn (I2 = 70%). For the other elements in PM2.5 and all elements in PM10 including PM10_S, non-significant HRs between 0.78 and 1.21 with mostly wide CIs were seen. No association was found between any of the elements and UADT cancer. The HR for PM2.5_S and gastric cancer was robust to adjustment for additional factors, including diet, and restriction to study participants with stable addresses over follow-up resulted in slightly higher effect estimates with a decrease in precision. In a two-pollutant model, the effect estimate for total PM2.5 decreased whereas that for PM2.5_S was robust.
CONCLUSION:
This large multicentre cohort study shows a robust association between gastric cancer and long-term exposure to PM2.5_S but not PM10_S, suggesting that S in PM2.5 or correlated air pollutants may contribute to the risk of gastric cancer.
KEYWORDS:
Air pollution; Chemical elements; ESCAPE; Gastric cancer; Particulate matter components; Sulphur; Upper aerodigestive tract cancer

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Dietary calcium intake and hypertension risk: a dose-response meta-analysis of prospective cohort studies.
Jayedi A, Zargar MS.
Eur J Clin Nutr. 2018 Aug 10. doi: 10.1038/s41430-018-0275-y. [Epub ahead of print] Review.
PMID: 30097650
Abstract
The association of calcium intake with risk of developing hypertension in the general population has not been established yet. We systematically searched PubMed and Scopus databases up to February 2018 to find prospective observational studies investigating the association of calcium intake with risk of developing hypertension. The reported risk estimates were pooled using a random-effects model. Eight prospective cohort studies (248,398 participants and 30,838 cases) were included. Seven studies measured dietary calcium intake, but one study measured total calcium intake (calcium from food and supplements). A significant inverse association was found for the highest versus lowest category of calcium intake (relative risk: 0.89, 95%CI: 0.86, 0.93; I2 = 0%, n = 8), and for each 500 mg/d increment (relative risk: 0.93, 95%CI: 0.90, 0.97; I2 = 64%, n = 7). Summary results were the same with the main analyses when the analyses were restricted only to dietary calcium intake. A nonlinear dose-response meta-analysis exhibited a linear inverse association, with a somewhat steeper trend within the low and moderate intakes. In conclusion, higher dietary calcium intake, independent of adiposity and intake of other blood pressure-related minerals, is slightly associated with a lower risk of developing hypertension.

Assessment of the 11-year nationwide trend of out-of-hospital cardiac arrest cases among elderly patients in Japan (2005-2015).
Matsuyama T, Kitamura T, Kiyohara K, Kiguchi T, Kobayashi D, Nishiyama C, Iwami T, Ohta B.
Resuscitation. 2018 Aug 9. pii: S0300-9572(18)30726-3. doi: 10.1016/j.resuscitation.2018.08.011. [Epub ahead of print]
PMID: 30099119
https://sci-hub.tw/10.1016/j.resuscitation.2018.08.011
Abstract
OBJECTIVE:
Japan has one of the most rapidly aging societies worldwide. This study aimed to assess the long-term nationwide trend of out-of-hospital cardiac arrest (OHCA) cases among elderly patients in Japan.
METHODS:
This prospective, nationwide observational study in Japan included elderly patients aged ≥65 years who experienced OHCA from January 1, 2005 to December 31, 2015. The patients were classified into three groups: young-old, aged 65-74 years; old-old, aged 75-84 years; and oldest-old, aged ≥85 years. The primary outcome of this study was one-month survival with a favorable neurological outcome, which was defined as a cerebral performance category scale score of 1 or 2.
RESULTS:
A total of 877,009 patients were included in our analysis. The number of elderly patients with OHCA increased from 65,968 in 2005 to 87,339 in 2015, and each age category showed a significantly increasing trend (p value <0.001 for each trend). The proportions of favorable neurological outcomes also increased from 1.2% in 2005 to 2.8% in 2015 in the young-old group; from 0.6% in 2005 to 1.1% in 2015 in the old-old group; and from 0.2% in 2005 to 0.5% in 2014 in the oldest-old group. Furthermore, this improving trend was notable for those with a shockable first documented rhythm.
CONCLUSIONS:
Based on this long-term nationwide observational study in Japan, the number of elderly patients with OHCA increased annually, and a significant improvement in the patients' neurological outcomes was noted regardless of age category, particularly among those with an initially shockable rhythm.
KEYWORDS:
cardiopulmonary; elderly; long-term trend; out-of-hospital cardiac arrest; resuscitation

Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases.
Pavlidou E, Mantzorou M, Fasoulas A, Tryfonos C, Petridis D, Giaginis C.
Diseases. 2018 Aug 8;6(3). pii: E73. doi: 10.3390/diseases6030073. Review.
PMID: 30096779
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276415/
Abstract
INTRODUCTION:
Moderate wine consumption is a characteristic of the Mediterranean diet. Studies around the world have shown a beneficial effect of moderate alcohol intake, especially wine, on health. This review aims to critically summarise the most recent studies that investigate the beneficial effects of moderate wine intake on human health.
METHODS:
The PubMed database was comprehensively searched to identify trials published from 2013 to 2018 that investigated the association between moderate wine consumption and health.
RESULTS:
The most recent studies confirm the valuable role of moderate wine consumption, especially red wine, in the prevention and treatment of chronic diseases such as cardiovascular disease, metabolic syndrome, cognitive decline, depression, and cancer. In the meantime, recent studies also highlight the beneficial role of red wine against oxidative stress and in favour of desirable gut bacteria. The beneficial role of red wine has been attributed to its phytochemical compounds, as highlighted by clinical trials, where the effect of red wine has been compared to white wine, non-alcoholic wine, other alcoholic drinks, and water.
CONCLUSIONS:
Moderate wine intake, at 1⁻2 glasses per day as part of the Mediterranean diet, has been positively associated with human health promotion, disease prevention, and disease prognosis.
KEYWORDS:
cardiovascular disease; dementia; diet; health; vine; wine

Reaction times match IQ for major causes of mortality: Evidence from a population based prospective cohort study.
Der G, Deary IJ.
Intelligence. 2018 Jul-Aug;69:134-145. doi: 10.1016/j.intell.2018.05.005.
PMID: 30100646
https://www.sciencedirect.com/science/article/pii/S0160289618300230?via%3Dihub
Abstract
INTRODUCTION:
The association of premorbid cognitive ability with all-cause mortality is now well established. However, since all-cause mortality is relatively uninformative about aetiology, evidence has been sought, and is beginning to accumulate, for associations with specific causes of mortality. Likewise, the underlying causal pathways may be illuminated by considering associations with different measures of cognitive ability. For example, critics of IQ type measures point to possible cultural or social biases and there is, consequently, a need for more culturally neutral measures such as reaction times. We examine the associations of cognitive ability with major causes of mortality, including: cardiovascular disease, cancer and respiratory disease and compare the results for a standard IQ test, the Alice Heim 4 (AH4), with those for simple and four-choice reaction times.
METHODS:
Data were derived from the oldest cohort of the West of Scotland Twenty-07 Study. Participants were randomly sampled from the Central Clydeside Conurbation, a mainly urban area centred on Glasgow city. At baseline, aged 56, they were interviewed in their homes by trained interviewers; the AH4 was administered and reaction times measured using a portable electronic device. Vital status was ascertained via linkage to the NHS central register. Cox regression was used in SAS 9.4 for the main analyses. Adjustments were made for sex, smoking status and social class.
RESULTS:
Full data on AH4, RT and covariates were available for 1350 out of 1551. During 29 years of follow-up, there were 833 deaths: 279 cardiovascular disease (CVD) (168 CHD; 68 stroke); 291 cancer; 97 respiratory disease; 42 digestive disease; and 39 dementia. The 85 remaining deaths were a heterogeneous mixture with no cause accounting for more than 14.AH4 scores were associated with most major causes. Digestive disease and dementia had similar effect sizes but were not significant. Within cardiovascular disease, there was an association with coronary heart disease but not stroke. The association with cancer was primarily due to those cancers related to smoking.RT measures were mostly associated with the same causes of death. Where significant, effects were in the same directions and of similar magnitude. That is, lower AH4 scores, longer reaction times, and more variable reaction times were all associated with increased mortality risk from the major causes of death. A summary measure of RT outperformed the AH4 for most causes.
CONCLUSION:
The association between intelligence with mortality from the major causes is also seen with reaction times. That effect sizes are of similar magnitude is suggestive of a common cause. It also implies that the association of cognitive ability with mortality is unlikely to be due to any social, cultural or educational biases that are sometimes ascribed to intelligence measures.

Population attributable fractions of the main type 2 diabetes risk factors in women: findings from the French E3N Cohort.
Rajaobelina K, Dow C, Mancini FR, Dartois L, Boutron-Ruault MC, Balkau B, Bonnet F, Fagherazzi G.
J Diabetes. 2018 Aug 11. doi: 10.1111/1753-0407.12839. [Epub ahead of print]
PMID: 30098121
Abstract
BACKGROUND:
Though many type 2 diabetes (T2D) risk factors have been identified, little is known on their contributions to the diabetes burden at the population level.
METHODS:
The study included, 72 655 French women from the E3N prospective cohort followed between 1993 and 2011. We used Cox multivariable models including the main T2D risk factors (metabolic, dietary, clinical, socio-economic and hormonal), as well as a healthy lifestyle index combining five characteristics (smoking, body mass index (BMI), alcohol consumption, fruit and vegetable consumption and physical activity) to estimate hazard ratios and population attributable fractions (PAFs) for T2D.
RESULTS:
In multivariate models, factors with the strongest impact on T2D risk were in decreasing order BMI ≥ 30 kg/m2 (PAF =43% ; 95%CI 37, 47), high adherence to a Western dietary pattern (PAF =30%, 95%CI= 20, 40), hypertension (PAF =26%, 95%CI = 20, 32), an acidogenic diet (PAF =24%, 95 %CI =16, 32), family history of diabetes (PAF =20%, 95%CI = 17, 22), and in a negative way, moderate alcohol consumption (PAF =-19%, 95 %CI = -34,- 4). The PAF to an unhealthy lifestyle was 57% (95% CI 50, 63).
CONCLUSIONS:
We have been able to sort out and quantify the impact of various dietary and biological T2D risk factors simultaneously in a single population, and to highlight the importance of a healthy lifestyle for primary prevention: more than half of the cases could have been prevented through a healthier lifestyle. This article is protected by copyright. All rights reserved.
KEYWORDS:
Type 2 diabetes; lifestyle; nutrition; population attributable fraction

The Association of Serum Carotenoids, Tocopherols, and Ascorbic Acid With Rapid Kidney Function Decline: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.
Hirahatake KM, Jacobs DR, Gross MD, Bibbins-Domingo KB, Shlipak MG, Mattix-Kramer H, Odegaard AO.
J Ren Nutr. 2018 Aug 8. pii: S1051-2276(18)30129-8. doi: 10.1053/j.jrn.2018.05.008. [Epub ahead of print]
PMID: 30098859
Abstract
OBJECTIVE:
Nutritional intervention targeting dietary intake modification is a major component of treatment for chronic kidney disease; however, little is known about the relationship between dietary intake and kidney function decline in individuals with preserved kidney function.
DESIGN AND METHODS:
In this prospective cohort study we examined the association of biomarkers of dietary intake with kidney function decline over a 5-year interval in 2,152 men and women with cystatin-C-based estimated glomerular filtration rate > 60 mL/minute/1.73 m2 from the Coronary Artery Risk Development in Young Adults study. The biomarkers of interest included carotenoids, tocopherols, and ascorbic acid. Multivariable logistic regression was used to explore the relationship between serum concentrations of the sum of 4 carotenoids (α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin), lycopene, α-tocopherol, γ-tocopherol, and ascorbic acid and rapid kidney function decline, defined as .15% decline in cystatin-C-based estimated glomerular filtration rate over 5 years.
RESULTS:
During the 5-year follow-up, 290 participants (13.5%) experienced rapid kidney function decline. Relative to individuals in the lowest quartile of serum carotenoids, those in the highest quartile had significantly lower odds of rapid kidney function decline in the fully adjusted model (odds ratio, 0.51; 95% confidence interval [CI], 0.32-0.80; P trend, .02). No association of levels of serum tocopherols, ascorbic acid, or lycopene with kidney function decline was found. There was no evidence that results differed for individuals with hypertension or diabetes.
CONCLUSIONS:
These results demonstrate that higher serum carotenoid levels, reflective of a fruit- and vegetable-rich dietary pattern, inversely associate with rapid kidney function decline in early middle adulthood and provide insight into how diet might play a role in chronic kidney disease prevention.

Folate and Its Impact on Cancer Risk.
Pieroth R, Paver S, Day S, Lammersfeld C.
Curr Nutr Rep. 2018 Aug 11. doi: 10.1007/s13668-018-0237-y. [Epub ahead of print] Review.
PMID: 30099693
https://link.springer.com/content/pdf/10.1007%2Fs13668-018-0237-y.pdf
Abstract
PURPOSE OF REVIEW:
Research has evaluated the potential impact of folate on cancer risk with conflicting findings. Studies have demonstrated increased risk, no effect, and decreased risk. This review summarizes findings of mixed results between folate intake, serum levels, gene polymorphisms, and cancer risk based on meta-analyses from the past five years.
RECENT FINDING:
Low or deficient folate status is associated with increased risk of many cancers. Folic acid supplementation and higher serum levels are associated with increased risk of prostate cancer. Gene polymorphisms may impact risk in certain ethnic groups. Folate has been studied extensively due to its role in methylation and nucleotide synthesis. Further prospective studies are needed to clarify optimal levels for nutrient remediation and risk reduction in those at risk, as well as elucidate the association between high intake, high serum levels, and prostate cancer risk. Future considerations for cancer risk may include gene interactions with nutrients and environmental factors.
KEYWORDS:
Cancer risk; Folate; Folate deficiency; Folate supplementation; Folic acid; MTHFR; SHMT; Serum folate

Walnut diets up-regulate the decreased hippocampal neurogenesis and age-related cognitive dysfunction in d-galactose induced aged rats.
An L, Sun Y, Zhang W, Huang X, Xue R, Zhang Y, Wang Y.
Food Funct. 2018 Aug 13. doi: 10.1039/c8fo00702k. [Epub ahead of print]
PMID: 30101966
Abstract
Recently, dietary intervention has been considered as a prospective strategy in delaying age-related cognitive dysfunction and brain plasticity degeneration. This study explored the effect of walnut diets (6% and 9%, 8 weeks) on cognitive behavior, hippocampal neurogenesis and the neurotrophic signaling pathway in d-galactose (d-gal) model rats. Behavioral tests showed that walnut diets significantly reversed spatial memory loss in the Morris water test, locomotor activity deficiency in an open field test, and a recognition behavior reduction in a novel object recognition task. Immunohistochemistry analysis demonstrated walnut diets significantly increased the hippocampal neurogenesis in d-gal model rats. Moreover, western blot results indicated that walnut diets reserved a d-gal induced decrease of hippocampal pCREB (Ser133) and BDNF expression, two crucial intracellular molecules involved in hippocampal neurogenesis. These findings confirmed that chronic walnut-rich diets could ameliorate cognitive dysfunction in d-gal model rats, and the up-regulation of neurogenesis, as well as the expression of pCREB and BDNF in hippocampus, may be one of the molecular and cellular mechanisms underlying these effects.

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Pattern of mortality after menopausal hormone therapy: long-term follow-up in a population based cohort.
Holm M, Olsen A, Au Yeung SL, Overvad K, Lidegaard Ø, Kroman N, Tjønneland A.
BJOG. 2018 Aug 14. doi: 10.1111/1471-0528.15433. [Epub ahead of print]
PMID: 30106241
https://sci-hub.tw/https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.15433
Abstract
OBJECTIVE:
To investigate long-term pattern of mortality in menopausal women according to different modalities of hormone therapy.
DESIGN:
Population based prospective cohort study.
SETTING:
Denmark 1993-2013.
POPULATION:
29,243 women aged 50-64 years at entry into the Diet, Cancer, and Health Cohort, enrolled 1993-1997 and followed through December 31, 2013.
METHODS:
Cox' proportional hazards models for increasingly longer periods of follow up time were used to estimate mortality pattern according to baseline hormone use adjusted for relevant potential confounders.
MAIN OUTCOME:
All cause and cause specific mortality. Outcome information was obtained from the Danish Causes of Death Registry (linkage 99.6%).
RESULTS:
4,098 women died during a median follow-up of 17.6 years. After adjustment for relevant lifestyle risk factors, hormone use had no impact on all-cause mortality, regardless of modality. Among baseline users lower CVD mortality was only evident after 5 years (HR 0.54; 95% CI: 0.32-0.92), but dissipated with additional follow-up. Reversely, lower colorectal cancer mortality (HR 0.64; 95% CI 0.46-0.89), and higher breast cancer mortality (HR 1.34; 95% CI 1.05-1.72) only became evident after 15 years follow-up. There were no significant associations for mortality from other types of cancer or from stroke.
CONCLUSIONS:
In this long-term follow-up study, taking hormones during menopause was not associated with overall mortality among middle-aged women. Investigating cause-specific mortality revealed significant albeit weak associations differential according to both causes of death and over time underlining the importance of carefully considering individual risks and duration of treatment when making decisions on hormone therapy.
KEYWORDS:
all-cause mortality; cause-specific mortality; menopausal hormone therapy; time-varying mortality estimates

Differential Effects of High Sugar, High Lard or a Combination of Both on Nutritional, Hormonal and Cardiovascular Metabolic Profiles of Rodents.
Matias AM, Estevam WM, Coelho PM, Haese D, Kobi JBBS, Lima-Leopoldo AP, Leopoldo AS.
Nutrients. 2018 Aug 11;10(8). pii: E1071. doi: 10.3390/nu10081071.
PMID: 30103515
http://www.mdpi.com/2072-6643/10/8/1071/htm
Abstract
BACKGROUND:
Dietary interventions in rodents can induce an excess of adipose tissue and metabolic disorders that resemble human obesity. Nevertheless, these approaches are not standardized, and the phenotypes may vary distinctly among studies. The aim of this study was to investigate the effects of different dietary interventions on nutritional, metabolic, biochemical, hormonal, and cardiovascular profiles, as well as to add to development and characterization of an experimental model of obesity.
METHODS:
Male Wistar rats were randomized into four groups: control diet (C), high-sugar (HS), high-fat (HF), or high-sugar and high-fat (HFHS). Weekly measurements of body weight, adiposity, area under the curve (AUC) for glucose, blood pressure (BP) and serum triglycerides, total cholesterol level, and leptin were performed.
RESULTS:
HF and HFHS models were led to obesity by increases in adipose tissue deposition and the adiposity index. All hypercaloric diets presented systolic BP increases. In addition, the AUC for glucose was greater in HF and HFHS than in C, and only the HF group presented hyperleptinemia.
CONCLUSIONS:
HF and HFHS diet approaches promote obesity and comorbidities, and thus represent a useful tool for studying human obesity-related disorders. By contrast, the HS model did not prove to be a good model of obesity.
KEYWORDS:
comorbidities; experimental model; hypercaloric diets; obesity; rodents

Dietary n-6 polyunsaturated fatty acids and cardiovascular disease: Epidemiologic evidence.
Wang DD.
Prostaglandins Leukot Essent Fatty Acids. 2018 Aug;135:5-9. doi: 10.1016/j.plefa.2018.05.003. Epub 2018 May 29. Review.
PMID: 30103933
Abstract
Epidemiologists have been studying the effect of n-6 polyunsaturated fatty acids (PUFAs) intake on the risk of cardiovascular disease (CVD) for many decades. Abundant evidence from prospective studies on the clinical endpoints of CVD, including cohort studies measuring n-6 PUFA intake by food frequency questionnaires and nested case-control studies using biomarkers of intake level, strongly support that higher intakes of n-6 PUFAs are associated with a lower risk of CVD. Furthermore, a significant reduction in CVD risk can be achieved when saturated fatty acids (SFAs) is replaced by n-6 PUFAs. Evidence from appropriately designed and vigorously executed randomized controlled trials support that high-PUFA (predominantly linoleic acid) and low-SFA diets, compared to high-SFA diets, reduced the risk of coronary heart disease. Overall, epidemiologic studies provide a solid evidence base of the current dietary guidelines that recommend replacing SFA by PUFA, both n-6 and n-3 PUFA, for CVD prevention.
KEYWORDS:
Cardiovascular disease; Coronary heart disease; Linoleic acid; Stroke; n-6 polyunsaturated fatty acid

Diet-Related Risk Factors for Incident Hypertension During an 11-Year Follow-Up: The Korean Genome Epidemiology Study.
Lee HA, Park H.
Nutrients. 2018 Aug 13;10(8). pii: E1077. doi: 10.3390/nu10081077.
PMID: 30104485
http://www.mdpi.com/2072-6643/10/8/1077/htm
Abstract
Using long-term follow-up cohort data from the Korean Genome Epidemiology Study, we assessed the dietary risk factors for incident hypertension (HTN). In total, 6792 subjects (3300 males and 3492 females) aged 40⁻69 years were included in the study. Physician-diagnosed HTN self-reported by the participants was used as the outcome. Daily intake of 20 food groups was assessed while using a dish-based semi-quantitative food-frequency questionnaire. After controlling for known risk factors, the food groups that were most closely associated with HTN were identified by forward stepwise selection while using the Cox proportional hazards model. The median follow-up period was 11.5 years (interquartile range, 6.0⁻11.7 years) and the incidence of HTN was 20 per 1000 person-years. Older age, obesity, lower education level, high alcohol intake, and having at least one parent with HTN were associated with the risk for HTN. In addition, a high intake of salted seafood and a low intake of eggs and meat were independently associated with the incidence of HTN after controlling for the known risk factors. Those in the top quartile of salted seafood intake had a 28% greater risk for incident HTN than those in the bottom quartile. The population-attributable fraction of three dietary factors accounted for 29.0% of the incidence of HTN. A high intake of salted seafood and a low intake of eggs and meat were associated with a greater risk for HTN.
KEYWORDS:
dietary risk factors; hypertension; population-attributable fraction; prospective cohort study

Vegetable Diversity, Injurious Falls, and Fracture Risk in Older Women: A Prospective Cohort Study.
Sim M, Blekkenhorst LC, Lewis JR, Bondonno CP, Devine A, Zhu K, Woodman RJ, Prince RL, Hodgson JM.
Nutrients. 2018 Aug 13;10(8). pii: E1081. doi: 10.3390/nu10081081.
PMID: 30104494
Abstract
The importance of vegetable diversity for the risk of falling and fractures is unclear. Our objective was to examine the relationship between vegetable diversity with injurious falling and fractures leading to hospitalization in a prospective cohort of older Australian women (n = 1429, ≥70 years). Vegetable diversity was quantified by assessing the number of different vegetables consumed daily. Vegetable intake (75 g servings/day) was estimated using a validated food frequency questionnaire at baseline (1998). Over 14.5 years, injurious falls (events = 568, 39.7%), and fractures (events = 404, 28.3%) were captured using linked health records. In multivariable-adjusted Cox regression models, women with greater vegetable diversity (per increase in one different vegetable/day) had lower relative hazards for falls (8%; p = 0.02) and fractures (9%; p = 0.03). A significant interaction between daily vegetable diversity (number/day) and total vegetable intake (75 g servings/day) was observed for falls (pinteraction = 0.03) and fractures (pinteraction < 0.001). The largest benefit of higher vegetable diversity were observed in the one third of women with the lowest vegetable intake (<2.2 servings/day; falls HR 0.83 95% CI (0.71⁻0.98); fractures HR 0.74 95% CI (0.62⁻0.89)). Increasing vegetable diversity especially in older women with low vegetable intake may be an effective way to reduce injurious fall and fracture risk.
KEYWORDS:
ageing; epidemiology; geriatrics; injury; musculoskeletal health; nutrition

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Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases.
Pavlidou E, Mantzorou M, Fasoulas A, Tryfonos C, Petridis D, Giaginis C.
Diseases. 2018 Aug 8;6(3). pii: E73. doi: 10.3390/diseases6030073. Review.
PMID: 30096779
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276415/

 

Wrong link.   See:    http://www.mdpi.com/2079-9721/6/3/73/htm

(But thanks Al for all your work!)

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An Oral Combination of Vitamins A, C, E, and Mg++ Improves Auditory Thresholds in Age-Related Hearing Loss.
Alvarado JC, Fuentes-Santamaría V, Gabaldón-Ull MC, Juiz JM.
Front Neurosci. 2018 Jul 31;12:527. doi: 10.3389/fnins.2018.00527. eCollection 2018.
PMID: 30108480
https://www.frontiersin.org/articles/10.3389/fnins.2018.00527/full
Abstract
The increasing rate of age-related hearing loss (ARHL), with its subsequent reduction in quality of life and increase in health care costs, requires new therapeutic strategies to reduce and delay its impact. The goal of this study was to determine if ARHL could be reduced in a rat model by administering a combination of antioxidant vitamins A, C, and E acting as free radical scavengers along with Mg++, a known powerful cochlear vasodilator (ACEMg). Toward this goal, young adult, 3 month-old Wistar rats were divided into two groups: one was fed with a diet composed of regular chow ("normal diet," ND); the other received a diet based on chow enriched in ACEMg ("enhanced diet," ED). The ED feeding began 10 days before the noise stimulation. Auditory brainstem recordings (ABR) were performed at 0.5, 1, 2, 4, 8, 16, and 32 kHz at 3, 6-8, and 12-14 months of age. No differences were observed at 3 months of age, in both ND and ED animals. At 6-8 and 12-14 months of age there were significant increases in auditory thresholds and a reduction in the wave amplitudes at all frequencies tested, compatible with progressive development of ARHL. However, at 6-8 months threshold shifts in ED rats were significantly lower in low and medium frequencies, and wave amplitudes were significantly larger at all frequencies when compared to ND rats. In the oldest animals, differences in the threshold shift persisted, as well as in the amplitude of the wave II, suggesting a protective effect of ACEMg on auditory function during aging. These findings indicate that oral ACEMg may provide an effective adjuvant therapeutic intervention for the treatment of ARHL, delaying the progression of hearing impairment associated with age.
KEYWORDS:
age-related hearing loss; aging; auditory brainstem response; hearing loss; magnesium; micronutrients; presbycusis; vitamins

"We did not have data on plain water intake."
Water intake from foods and beverages and risk of mortality from CVD: the Japan Collaborative Cohort (JACC) Study.
Cui R, Iso H, Eshak ES, Maruyama K, Tamakoshi A; JACC Study Group.
Public Health Nutr. 2018 Aug 15:1-7. doi: 10.1017/S1368980018001386. [Epub ahead of print]
PMID: 30107863
https://sci-hub.tw/10.1017/S1368980018001386
Abstract
OBJECTIVE:
To examine the association of water intake with risk of mortality from CVD.
DESIGN:
Prospective cohort study.Setting/SubjectsA total of 22 939 men and 35 362 women aged 40-79 years enrolled in the Japan Collaborative Cohort (JACC) Study with available data regarding water intake from foods and beverages. The underlying causes of death were determined based on the International Classification of Diseases.
RESULTS:
During the median 19·1 years of follow-up, 1637 men and 1707 women died from CVD. There was an inverse trend between high water intake and risk of CVD in both sexes. Compared with participants in the lowest quintile of water intake, the multivariable-adjusted hazard ratios (95 % CI) for mortality from total CVD in the highest quintile of water intake were 0·88 (0·72, 1·07; P for trend=0·03) in men and 0·79 (0·66, 0·95; P for trend=0·10) in women. Those for CHD were 0·81 (0·54, 1·21; P for trend=0·06) in men and 0·60 (0·39, 0·93; P for trend=0·20) in women. Reduced risk of mortality from ischaemic stroke was also observed among women in the highest water intake quintile: 0·70 (0·47, 0·99; P for trend=0·19). There was no association between water intake and mortality from haemorrhagic stroke in either sex.
CONCLUSIONS:
Higher intake of fluids from foods and beverages was associated with reduced risk of cardiovascular mortality in both sexes and reduced risk of ischaemic stroke in women in Japan.
KEYWORDS:
CHD; Cardiovascular mortality; Japanese; Moisture in foods and beverages; Stroke; Water

Varying Effects of Body Mass Index and Mortality in Different Risk Groups.
Lamelas P, Schwalm JD, Leong D, Jolly S, Mehta S, Bangdiwala S, Yusuf S.
Am J Cardiol. 2018 Jul 4. pii: S0002-9149(18)31330-4. doi: 10.1016/j.amjcard.2018.06.038. [Epub ahead of print]
PMID: 30107907
https://sci-hub.tw/10.1016/j.amjcard.2018.06.038
Abstract
It is unclear why high body mass index (BMI) is associated with a lower risk of death in patients with cardiovascular disease (CVD). We hypothesized that the impact of higher BMI varies by the patient's baseline risk of death. We analyzed data from 14 prospective studies conducted by us in 50 countries of 170,470 patients: 22.8% without CVD, 29.4% with stable CVD and 47.8% with acute coronary syndromes (ACS). Compared with overweight (BMI 25 to 29.9 kg/m2), normal weight (BMI 20 to 24.9 kg/m2), and underweight (BMI < 20 kg/m2) were associated with higher mortality in all cohorts. Compared with overweight, the risk of death among those with obesity (BMI ≥ 30 kg/m2) varied depending on the population studied: HR (95% confidence interval) in those without CVD, with stable CVD, and with ACS were 1.20 (1.01 to 1.45; p = 0.04), 1.08 (1.02 to 1.15; p = 0.01), and 1.01 (0.93 to 1.10; p = 0.72), respectively. The BMI associated with lowest mortality increased as cohort risk increased (no-CVD 27.2 kg/m2, stable CVD 28.1 kg/m2, and ACS 30.9 kg/m2; p <0.001). Within each cohort, the optimal BMI value was higher in the high-risk subgroup. In the ACS cohort, low-risk patients had an optimal BMI value of 29.1 kg/m2 while in the high-risk group higher BMI was associated with lower risk of death (interaction-p <0.001). In conclusion, between and within cohorts of people without CVD, stable CVD, and ACS, higher BMI was associated with lower risk of death in higher risk groups. The benefits of increased body fat (i.e., increased caloric reserve) may counteract the hazards in high-risk groups, suggesting an alternative explanation of the obesity paradox.

Prostate cancer risk factors in black and white men in the NIH-AARP Diet and Health Study.
Layne TM, Graubard BI, Ma X, Mayne ST, Albanes D.
Prostate Cancer Prostatic Dis. 2018 Aug 14. doi: 10.1038/s41391-018-0070-9. [Epub ahead of print]
PMID: 30108373
http://sci-hub.tw/http://www.nature.com/articles/s41391-018-0070-9
Abstract
BACKGROUND:
There are few prospective studies comparing race-specific associations between diet, nutrients, and health-related parameters, and prostate cancer risk.
METHODS:
Race-specific prostate cancer risk associations were examined among men in the National Institutes of Health (NIH)-AARP Diet and Health Study. We identified 1417 cases among black men (209 advanced), and 28,845 among white men (3898 advanced). Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). We also evaluated the cumulative change in the HR for black race following adjustment for each factor.
RESULTS:
Race-specific prostate cancer associations were similar in black and white men across disease subtypes only for history of diabetes (overall : HR = 0.77, 95% CI: 0.65-0.90 and HR = 0.72, 95% CI: 0.69-0.76, respectively; Pinteraction = 0.66). By contrast, there was a positive risk association with height for white men  and  inverse for black men (Pinteraction: non-advanced = 0.01; advanced = 0.04). This difference remained among men with at least 2 years of follow-up for non-advanced (Pinteraction = 0.01), but not advanced disease (Pinteraction = 0.24); or after adjustment for prostate cancer screening (non-advanced Pinteraction = 0.53, advanced Pinteraction = 0.31). The only other evidence of interaction with race was observed for dietary vitamin D intake and non-advanced disease, but only after adjustment for screening (Pinteraction = 0.02). Cumulative adjustment for each factor increased the HR for black race by 32.9% for overall cancer and 12.4% for advanced disease.
CONCLUSIONS:
Our data suggest few of the dietary, nutrient, and health-related factors associated with prostate cancer risk in predominantly non-Hispanic white men were associated with risk in black men, and adjustment for these factors widen the black-white difference in risk. Larger studies of black men, particularly with prospective data, are needed to help identify risk factors relevant to this population.

Circulating plasma phospholipid fatty acids and risk of pancreatic cancer in a large European cohort.
Matejcic M, Lesueur F, Biessy C, Renault AL, Mebirouk N, Yammine S, Keski-Rahkonen P, Li K, Hémon B, Weiderpass E, Rebours V, Boutron-Ruault MC, Carbonnel F, Kaaks R, Katzke V, Kuhn T, Boeing H, Trichopoulou A, Palli D, Agnoli C, Panico S, Tumino R, Sacerdote C, Quirós JR, Duell EJ, Porta M, Sánchez MJ, Chirlaque MD, Barricarte A, Amiano P, Ye W, Peeters PH, Khaw KT, Perez-Cornago A, Key TJ, Bueno-de-Mesquita HB, Riboli E, Vineis P, Romieu I, Gunter MJ, Chajès V.
Int J Cancer. 2018 Aug 15. doi: 10.1002/ijc.31797. [Epub ahead of print]
PMID: 30110135
Abstract
There are both limited and conflicting data on the role of dietary fat and specific fatty acids in the development of pancreatic cancer. In this study, we investigated the association between plasma phospholipid fatty acids and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The fatty acid composition was measured by gas chromatography in plasma samples collected at recruitment from 375 incident pancreatic cancer cases and 375 matched controls. Associations of specific fatty acids with pancreatic cancer risk were evaluated using multivariable conditional logistic regression models with adjustment for established pancreatic cancer risk factors. Statistically significant inverse associations were found between pancreatic cancer incidence and levels of heptadecanoic acid (ORT3-T1 [odds ratio for highest versus lowest tertile] =0.63; 95%CI[confidence interval]=0.41-0.98; Ptrend =0.036), n-3 polyunsaturated α-linolenic acid (ORT3-T1 =0.60; 95%CI=0.39-0.92; Ptrend =0.02) and docosapentaenoic acid (ORT3-T1 =0.52; 95%CI=0.32-0.85; Ptrend =0.008). Industrial trans-fatty acids were positively associated with pancreatic cancer risk among men (ORT3-T1 =3.00; 95%CI=1.13-7.99; Ptrend =0.029), while conjugated linoleic acids were inversely related to pancreatic cancer among women only (ORT3-T1 =0.37; 95%CI=0.17-0.81; Ptrend =0.008). Among current smokers, the long-chain n-6/n-3 polyunsaturated fatty acids ratio was positively associated with pancreatic cancer risk (ORT3-T1 =3.40; 95%CI=1.39-8.34; Ptrend =0.007). Results were robust to a range of sensitivity analyses. Our findings suggest that higher circulating levels of saturated fatty acids with an odd number of carbon atoms and n-3 polyunsaturated fatty acids may be related to lower risk of pancreatic cancer. The influence of some fatty acids on the development of pancreatic cancer may be sex-specific and modulated by smoking.
KEYWORDS:
biomarkers; fatty acids; pancreatic cancer; plasma phospholipids; tobacco smoking

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Brain Health across the Lifespan: A Systematic Review on the Role of Omega-3 Fatty Acid Supplements.
Derbyshire E.
Nutrients. 2018 Aug 15;10(8). pii: E1094. doi: 10.3390/nu10081094. Review.
PMID: 30111738
[Access free pdf from https://www.ncbi.nlm.nih.gov/pubmed/30111738 .]
Abstract
The brain is the most significant and complex organ of the human body. Increasingly, we are becoming aware that certain nutrients may help to safeguard brain health. An expanse of research has investigated the effects of omega fatty acids in relation to brain health but effects across the lifespan have not been widely evaluated. The present systematic review collated evidence from 25 randomized controlled trials (n = 3633) published since 2013. Compared with control groups, omega-3 supplementation generally correlated with improvements in blood biomarkers. Subsequently, these appear to benefit those with lower baseline fatty acid levels, who are breastfeeding or who have neuropsychiatric conditions. Whilst multiple studies indicate that omega fatty acids can protect against neurodegeneration in older adults, more work is needed in the years preceding the diagnosis of such medical conditions. Bearing in mind the scale of ageing populations and rising healthcare costs linked to poor brain health, omega supplementation could be a useful strategy for helping to augment dietary intakes and support brain health across the lifespan. Ongoing research is now needed using harmonious methodologies, supplement dosages, ratios and intervention periods to help formulate congruent conclusions.
KEYWORDS:
brain health; cognition; learning; mindfulness; omega-3 fatty acids

Effect of whey protein supplementation after resistance exercise on the muscle mass and physical function of healthy older women: A randomized controlled trial.
Mori H, Tokuda Y.
Geriatr Gerontol Int. 2018 Aug 16. doi: 10.1111/ggi.13499. [Epub ahead of print]
PMID: 30113122
https://onlinelibrary.wiley.com/doi/full/10.1111/ggi.13499
https://onlinelibrary.wiley.com/doi/epdf/10.1111/ggi.13499
Abstract
AIM:
To evaluate the effectiveness of a 24-week program of nutritional supplementation using whey protein, ingested after resistance exercise, in increasing muscle mass and physical function among community-dwelling healthy older Japanese women.
METHODS:
We carried out a randomized controlled trial, with 81 healthy women, aged 65-80 years, allocated to three groups of 27 participants each: the exercise and protein supplementation group, the exercise only group, and the protein supplementation only group. A 24-week program of resistance exercise, carried out twice per week, was combined with whey protein supplementation, containing 22.3 g of protein. The total protein intake for participants in all three experimental groups was adjusted to a level of at least 1.2 g/kg bodyweight/day, and more during the intervention period. Between-group differences in the pre- to post-intervention change in skeletal muscle mass and physical function were evaluated using an analysis of variance.
RESULTS:
The pre- to post-intervention increase in the skeletal muscle mass index was significantly higher for the exercise only group than for the protein supplementation only group (P =0.008), and significantly higher for the exercise and protein supplementation group than for either the exercise only (P =0.007) or protein supplementation only (P <0.001) groups. Similarly, the increase in grip strength and gait speed was significantly greater for the exercise and protein supplementation group than for the protein supplementation only group (grip strength P =0.014, gait speed P =0.026).
CONCLUSIONS:
Whey protein supplementation, ingested after resistance exercise, could be effective for the prevention of sarcopenia among healthy community-dwelling older Japanese women.
KEYWORDS:
muscle mass; muscle strength; resistance exercise; total protein intake amount; whey protein

Development and Validation of the Korean Diabetes Risk Score: A 10-Year National Cohort Study.
Ha KH, Lee YH, Song SO, Lee JW, Kim DW, Cho KH, Kim DJ.
Diabetes Metab J. 2018 Jul 6. doi: 10.4093/dmj.2018.0014. [Epub ahead of print]
PMID: 30113144
https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-42-e25.pdf
Abstract
BACKGROUND:
A diabetes risk score in Korean adults was developed and validated.
METHODS:
This study used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) of 359,349 people without diabetes at baseline to derive an equation for predicting the risk of developing diabetes, using Cox proportional hazards regression models. External validation was conducted using data from the Korean Genome and Epidemiology Study. Calibration and discrimination analyses were performed separately for men and women in the development and validation datasets.
RESULTS:
During a median follow-up of 10.8 years, 37,678 cases (event rate=10.4 per 1,000 person-years) of diabetes were identified in the development cohort. The risk score included age, family history of diabetes, alcohol intake (only in men), smoking status, physical activity, use of antihypertensive therapy, use of statin therapy, body mass index, systolic blood pressure, total cholesterol, fasting glucose, and γ glutamyl transferase (only in women). The C-statistics for the models for risk at 10 years were 0.71 (95% confidence interval [CI], 0.70 to 0.73) for the men and 0.76 (95% CI, 0.75 to 0.78) for the women in the development dataset. In the validation dataset, the C-statistics were 0.63 (95% CI, 0.53 to 0.73) for men and 0.66 (95% CI, 0.55 to 0.76) for women.
CONCLUSION:
The Korean Diabetes Risk Score may identify people at high risk of developing diabetes and may be an effective tool for delaying or preventing the onset of condition as risk management strategies involving modifiable risk factors can be recommended to those identified as at high risk.
KEYWORDS:
Diabetes mellitus; Korea; Risk assessment; Risk factors

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Low-carb diets associated with lower life expectancy, study suggests
New research shows moderation is healthiest approach, nutrition experts say
Nicole Ireland, Christine Birak · CBC News · Posted: Aug 18, 2018 
http://www.cbc.ca/news/health/low-carb-diets-higher-mortality-lancet-study-1.4790046
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Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis
Sara B Seidelmann, Brian Claggett, Susan Cheng, Mir Henglin, Amil Shah, Lyn M Steffen, Aaron R Folsom, Eric B Rimm, Walter C Willett, Scott D Solomon
Lancet Public Health Open Access Published:August 16, 2018 DOI:https://doi.org/10.1016/S2468-2667(18)30135-X
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext#
Summary
Background
Low carbohydrate diets, which restrict carbohydrate in favour of increased protein or fat intake, or both, are a popular weight-loss strategy. However, the long-term effect of carbohydrate restriction on mortality is controversial and could depend on whether dietary carbohydrate is replaced by plant-based or animal-based fat and protein. We aimed to investigate the association between carbohydrate intake and mortality.
Methods
We studied 15 428 adults aged 45–64 years, in four US communities, who completed a dietary questionnaire at enrolment in the Atherosclerosis Risk in Communities (ARIC) study (between 1987 and 1989), and who did not report extreme caloric intake (<600 kcal or >4200 kcal per day for men and <500 kcal or >3600 kcal per day for women). The primary outcome was all-cause mortality. We investigated the association between the percentage of energy from carbohydrate intake and all-cause mortality, accounting for possible non-linear relationships in this cohort. We further examined this association, combining ARIC data with data for carbohydrate intake reported from seven multinational prospective studies in a meta-analysis. Finally, we assessed whether the substitution of animal or plant sources of fat and protein for carbohydrate affected mortality.
Findings
During a median follow-up of 25 years there were 6283 deaths in the ARIC cohort, and there were 40 181 deaths across all cohort studies. In the ARIC cohort, after multivariable adjustment, there was a U-shaped association between the percentage of energy consumed from carbohydrate (mean 48·9%, SD 9·4) and mortality: a percentage of 50–55% energy from carbohydrate was associated with the lowest risk of mortality. In the meta-analysis of all cohorts (432 179 participants), both low carbohydrate consumption (<40%) and high carbohydrate consumption (>70%) conferred greater mortality risk than did moderate intake, which was consistent with a U-shaped association (pooled hazard ratio 1·20, 95% CI 1·09–1·32 for low carbohydrate consumption; 1·23, 1·11–1·36 for high carbohydrate consumption). However, results varied by the source of macronutrients: mortality increased when carbohydrates were exchanged for animal-derived fat or protein (1·18, 1·08–1·29) and mortality decreased when the substitutions were plant-based (0·82, 0·78–0·87).
Interpretation
Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.

This gene prevents elephants from getting cancer and scientists are taking note
Elephants should be among the highest risk for cancer with over 100 times more cells than humans
Torah Kachur · for CBC News · Posted: Aug 16, 2018
http://www.cbc.ca/news/canada/this-gene-prevents-elephants-from-getting-cancer-1.4787721
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Cell Rep. 2018 Aug 14;24(7):1765-1776. doi: 10.1016/j.celrep.2018.07.042.
A Zombie LIF Gene in Elephants Is Upregulated by TP53 to Induce Apoptosis in Response to DNA Damage.
Vazquez JM1, Sulak M1, Chigurupati S1, Lynch VJ2.
PMID: 30110634 DOI: 10.1016/j.celrep.2018.07.042
Abstract
Large-bodied organisms have more cells that can potentially turn cancerous than small-bodied organisms, imposing an increased risk of developing cancer. This expectation predicts a positive correlation between body size and cancer risk; however, there is no correlation between body size and cancer risk across species ("Peto's paradox"). Here, we show that elephants and their extinct relatives (proboscideans) may have resolved Peto's paradox in part through refunctionalizing a leukemia inhibitory factor pseudogene (LIF6) with pro-apoptotic functions. LIF6 is transcriptionally upregulated by TP53 in response to DNA damage and translocates to the mitochondria where it induces apoptosis. Phylogenetic analyses of living and extinct proboscidean LIF6 genes indicates that its TP53 response element evolved coincident with the evolution of large body sizes in the proboscidean stem lineage. These results suggest that refunctionalizing of a pro-apoptotic LIF pseudogene may have been permissive (although not sufficient) for the evolution of large body sizes in proboscideans.
KEYWORDS:
LIF; Peto’s paradox; apoptosis; cancer; elephant; refunctionalized pseudogene

Dietary protein and changes in markers of cardiometabolic health across 20 years of follow-up in middle-aged Americans.
Hruby A, Jacques PF.
Public Health Nutr. 2018 Aug 17:1-13. doi: 10.1017/S1368980018001854. [Epub ahead of print]
PMID: 30115136
Abstract
OBJECTIVE:
Dietary protein plays a role in counteracting age-related muscle loss. However, limited long-term data exist on protein intake and markers of cardiometabolic health, which tend to deteriorate with age.
DESIGN:
Prospective cohort study. FFQ-derived protein intake (g/d) and cardiometabolic markers were assessed up to five times across 20 years. Markers included systolic (SBP) and diastolic (DBP) blood pressures, circulating lipids (total, HDL and LDL cholesterol; TAG), estimated glomerular filtration rate (eGFR), fasting glucose (FG), weight and waist circumference (WC). Mixed models accounting for repeated measures were used to estimate adjusted mean annualized changes in outcomes per quartile category of protein.
SETTING:
Framingham Heart Study Offspring cohort, USA.
SUBJECTS:
Participants (n 3066) with 12 333 unique observations, baseline (mean (sd)) age=54·0 (9·7) years, BMI=27·4 (4·9) kg/m2, 53·5 % female.
RESULTS:
In fully adjusted models, there were favourable associations (mean (se)) of total protein with annualized changes in SBP (lowest v. highest intake: 0·34 (0·06) v. 0·04 (0·06) mmHg, P trend=0·001) and eGFR (-1·03 (0·06) v. -0·87 (0·05) ml/min per 1·73 m2, P trend=0·046), unfavourable associations with changes in FG (0·013 (0·004) v. 0·028 (0·004) mmol/l, P trend=0·004) and no associations with weight, WC, DBP or lipids. Animal protein was favourably associated with SBP and unfavourably with FG and WC; plant protein was favourably associated with FG and WC.
CONCLUSIONS:
The present study provides evidence that protein intake may influence changes in cardiometabolic health independent of change in weight in healthy adults and that protein's role in cardiometabolic health may depend on the protein source.
KEYWORDS:
Blood pressure; Dietary protein; Glucose; Lipids; Protein intake

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Dietary fiber intake is associated with a reduced risk of ovarian cancer: a dose-response meta-analysis.
Xu H, Ding Y, Xin X, Wang W, Zhang D.
Nutr Res. 2018 Sep;57:1-11. doi: 10.1016/j.nutres.2018.04.011. Epub 2018 Apr 25. Review.
PMID: 30122191
https://sci-hub.tw/10.1016/j.nutres.2018.04.011
Abstract
Dietary fiber may reduce the bioavailability of steroid hormones and favorably regulate insulin-like growth factor 1, and therefore may be associated with ovarian cancer risk. Current evidence on the association between dietary fiber intake and risk of ovarian cancer is inconsistent. Therefore, we conducted a meta-analysis to explore the association. We hypothesized that dietary fiber intake might be associated with a reduced risk of ovarian cancer. PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant articles up to September 2017. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated using random-effects model. Dose-response relationship was assessed by restricted cubic spline. A total of 19 studies involving 567 742 participants were included in this meta-analysis. The summary RR of the association between dietary fiber intake and ovarian cancer risk was 0.70 (95% CI, 0.57-0.87; I2 = 83.5%, Pheterogeneity < .001). In subgroup analyses, the above-mentioned significant inverse association was found among studies conducted in North America, case-control studies, and studies assessing the association of total fiber intake with ovarian cancer risk. Dose-response analysis suggested that ovarian cancer risk decreased by 3% (RR, 0.97; 95% CI, 0.95-0.99) for each 5-g/d increment in dietary fiber intake. This meta-analysis suggests that dietary fiber intake is associated with a reduced risk of ovarian cancer. Future intervention trials are needed to test the associations between different types of fiber (including soluble, insoluble, vegetable, fruit, cereal, and legumes fiber) and ovarian cancer risk.
KEYWORDS:
Diet; Dietary fiber; Dose-response; Meta-analysis; Ovarian cancer

Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis.
Seidelmann SB, Claggett B, Cheng S, Henglin M, Shah A, Steffen LM, Folsom AR, Rimm EB, Willett WC, Solomon SD.
Lancet Public Health. 2018 Aug 16. pii: S2468-2667(18)30135-X. doi: 10.1016/S2468-2667(18)30135-X. [Epub ahead of print]
PMID: 30122560
https://www.crsociety.org/topic/11801-als-papers-citations-and-possibly-links-and-excerpts-or-my-synopses/?page=22&tab=comments#comment-29618

Role of Physical Activity and Fitness in the Characterization and Prognosis of the Metabolically Healthy Obesity Phenotype: A Systematic Review and Meta-analysis.
Ortega FB, Cadenas-Sanchez C, Migueles JH, Labayen I, Ruiz JR, Sui X, Blair SN, Martínez-Vizcaino V, Lavie CJ.
Prog Cardiovasc Dis. 2018 Jul 6. pii: S0033-0620(18)30135-X. doi: 10.1016/j.pcad.2018.07.008. [Epub ahead of print] Review.
PMID: 30122522
Abstract
The aims of the present article are to systematically review and meta-analyze the existing evidence on: 1) differences in physical activity (PA), sedentary behavior (SB), cardiorespiratory fitness (CRF) and muscular strength (MST) between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO); and 2) the prognosis of all-cause mortality and cardiovascular disease (CVD) mortality/morbidity in MHO individuals, compared with the best scenario possible, i.e., metabolically healthy normal-weight (MHNW), after adjusting for PA, SB, CRF or MST. Our systematic review identified 67 cross-sectional studies to address aim 1, and 11 longitudinal studies to address aim 2. The major findings and conclusions from the current meta-analysis are: 1) MHO individuals are more active, spend less time in SB, and have a higher level of CRF (yet no differences in MST) than MUO individuals, suggesting that their healthier metabolic profile could be at least partially due to these healthier lifestyle factors and attributes. 2) The meta-analysis of cohort studies which accounted for PA (N = 10 unique cohorts, 100% scored as high-quality) support the notion that MHO individuals have a 24-33% higher risk of all-cause mortality and CVD mortality/morbidity compared to MHNW individuals. This risk was borderline significant/non-significant, independent of the length of the follow-up and lower than that reported in previous meta-analyses in this topic including all type of studies, which could be indicating a modest reduction in the risk estimates as a consequence of accounting for PA. 3) Only one study has examined the role of CRF in the prognosis of MHO individuals. This study suggests that the differences in the risk of all-cause mortality and CVD mortality/morbidity between MHO and MHNW are largely explained by differences in CRF between these two phenotypes.
KEYWORDS:
Cardiorespiratory fitness; Cardiovascular disease; Exercise; Metabolically health normal-weight; Metabolically healthy obesity; Metabolically unhealthy obesity; Mortality; Muscular strength; Obesity; Physical activity; Sedentary behaviors

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Nutrient Intake and Physical Exercise Significantly Impact Physical Performance, Body Composition, Blood Lipids, Oxidative Stress, and Inflammation in Male Rats.
Bloomer RJ, Schriefer JHM, Gunnels TA, Lee SR, Sable HJ, van der Merwe M, Buddington RK, Buddington KK.
Nutrients. 2018 Aug 17;10(8). pii: E1109. doi: 10.3390/nu10081109.
PMID: 30126091
http://www.mdpi.com/2072-6643/10/8/1109/htm
Abstract
BACKGROUND:
Humans consuming a purified vegan diet known as the "Daniel Fast" realize favorable changes in blood lipids, oxidative stress, and inflammatory biomarkers, with subjective reports of improved physical capacity.
OBJECTIVE:
We sought to determine if this purified vegan diet was synergistic with exercise in male rats.
METHODS:
Long⁻Evans rats (n = 56) were assigned to be exercise trained (+E) by running on a treadmill three days per week at a moderate intensity or to act as sedentary controls with normal activity. After the baseline physical performance was evaluated by recording run time to exhaustion, half of the animals in each group were fed ad libitum for three months a purified diet formulated to mimic the Daniel Fast (DF) or a Western Diet (WD). Physical performance was evaluated again at the end of month 3, and body composition was assessed using dual-energy x-ray absorptiometry. Blood was collected for measurements of lipids, oxidative stress, and inflammatory biomarkers.
RESULTS:
Physical performance at the end of month 3 was higher compared to baseline for both exercise groups (p < 0.05), with a greater percent increase in the DF + E group (99%) than in the WD + E group (51%). Body fat was lower in DF than in WD groups at the end of month 3 (p < 0.05). Blood triglycerides, cholesterol, malondialdehyde, and advanced oxidation protein products were significantly lower in the DF groups than in the WD groups (p < 0.05). No significant differences were noted in cytokines levels between the groups (p > 0.05), although IL-1β and IL-10 were elevated three-fold and two-fold in the rats fed the WD compared to the DF rats, respectively.
CONCLUSIONS:
Compared to a WD, a purified diet that mimics the vegan Daniel Fast provides significant anthropometric and metabolic benefits to rats, while possibly acting synergistically with exercise training to improve physical performance. These findings highlight the importance of macronutrient composition and quality in the presence of ad libitum food intake.
KEYWORDS:
cytokines; dietary restriction; free radicals; macronutrients; physical exercise

The role of dietary fibre in pig production, with a particular emphasis on reproduction.
Jarrett S, Ashworth CJ.
J Anim Sci Biotechnol. 2018 Aug 6;9:59. doi: 10.1186/s40104-018-0270-0. eCollection 2018. Review.
PMID: 30128149
https://jasbsci.biomedcentral.com/track/pdf/10.1186/s40104-018-0270-0
Abstract
Fibres from a variety of sources are a common constituent of pig feeds. They provide a means to utilise locally-produced plant materials which are often a by-product of the food or drink industry. The value of a high fibre diet in terms of producing satiety has long been recognised. However the addition of fibre can reduce feed intake, which is clearly detrimental during stages of the production cycle when nutrient needs are high, for example in growing piglets and during lactation. More recently, fibre has been found to promote novel benefits to pig production systems, particularly given the reduction in antimicrobial use world-wide, concern for the welfare of animals fed a restricted diet and the need to ensure that such systems are more environmentally friendly. For example, inclusion of dietary fibre can alter the gut microbiota in ways that could reduce the need for antibiotics, while controlled addition of certain fibre types may reduce nitrogen losses into the environment and so reduce the environmental cost of pig production. Of particular potential value is the opportunity to use crude fibre concentrates as 'functional' feed additives to improve young pig growth and welfare. Perhaps the greatest opportunity for the use of high fibre diets is to improve the reproductive efficiency of pigs. Increased dietary fibre before mating improves oocyte maturation, prenatal survival and litter size; providing a consumer-acceptable means of increasing the amount of saleable meat produced per sow. The mechanisms responsible for these beneficial effects remain to be elucidated. However, changes in plasma and follicular fluid concentrations of key hormones and metabolites, as well as effects of the hypothalamic satiety centre on gonadotrophin secretion and epigenetic effects are strong candidates.
KEYWORDS:
Fibre; Pig; Pregnancy; Production; Reproduction

Age dependency of risk factors for cognitive decline.
Legdeur N, Heymans MW, Comijs HC, Huisman M, Maier AB, Visser PJ.
BMC Geriatr. 2018 Aug 20;18(1):187. doi: 10.1186/s12877-018-0876-2.
PMID: 30126373
https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-018-0876-2
Abstract
BACKGROUND:
Risk factors for cognitive decline might depend on chronological age. The aim of the study was to explore the age dependency of risk factors for cognitive decline in cognitively healthy subjects aged 55-85 years at baseline.
METHODS:
We included 2527 cognitively healthy subjects from the Longitudinal Aging Study Amsterdam (LASA). Median follow-up was 9.1 (IQR: 3.2-19.0) years. The association of genetic and cardiovascular risk factors, depressive symptoms, inflammation markers and lifestyle risk factors with decline in MMSE and memory function was tested using spline regression analyses.
RESULTS:
Subjects were on average 70.1 (SD 8.8) years old at baseline. Based on a spline regression model, we divided our sample in three age groups: ≤70 years (young-old), > 70-80 years (old) and > 80 years (oldest-old). The association of LDL cholesterol, homocysteine, hypertension, history of stroke, depressive symptoms, interleukin-6, a1-antichymotrypsin, alcohol use and smoking with cognitive decline significantly differed between the age groups. In general, the presence of these risk factors was associated with less cognitive decline in the oldest-old group compared to the young-old and old group.
CONCLUSIONS:
The negative effect of various risk factors on cognitive decline decreases with higher age. A combination of epidemiological factors, such as the selection towards healthier subjects during follow-up, but also risk factor specific features, for example ensuring the cerebral blood flow in case of hypertension, explain this diminished association at higher age. It is important to take these age differences into account when applying preventive strategies to avert cognitive decline.
KEYWORDS:
Aging; Cognitive decline; Oldest-old; Risk factors

Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study.
Mente A, O'Donnell M, Rangarajan S, McQueen M, Dagenais G, Wielgosz A, Lear S, Ah STL, Wei L, Diaz R, Avezum A, Lopez-Jaramillo P, Lanas F, Mony P, Szuba A, Iqbal R, Yusuf R, Mohammadifard N, Khatib R, Yusoff K, Ismail N, Gulec S, Rosengren A, Yusufali A, Kruger L, Tsolekile LP, Chifamba J, Dans A, Alhabib KF, Yeates K, Teo K, Yusuf S.
Lancet. 2018 Aug 11;392(10146):496-506. doi: 10.1016/S0140-6736(18)31376-X. Epub 2018 Aug 9.
PMID: 30129465
https://sci-hub.tw/10.1016/S0140-6736(18)31376-X
Abstract
BACKGROUND:
WHO recommends that populations consume less than 2 g/day sodium as a preventive measure against cardiovascular disease, but this target has not been achieved in any country. This recommendation is primarily based on individual-level data from short-term trials of blood pressure (BP) without data relating low sodium intake to reduced cardiovascular events from randomised trials or observational studies. We investigated the associations between community-level mean sodium and potassium intake, cardiovascular disease, and mortality.
METHODS:
The Prospective Urban Rural Epidemiology study is ongoing in 21 countries. Here we report an analysis done in 18 countries with data on clinical outcomes. Eligible participants were adults aged 35-70 years without cardiovascular disease, sampled from the general population. We used morning fasting urine to estimate 24 h sodium and potassium excretion as a surrogate for intake. We assessed community-level associations between sodium and potassium intake and BP in 369 communities (all >50 participants) and cardiovascular disease and mortality in 255 communities (all >100 participants), and used individual-level data to adjust for known confounders.
FINDINGS:
95 767 participants in 369 communities were assessed for BP and 82 544 in 255 communities for cardiovascular outcomes with follow-up for a median of 8·1 years. 82 (80%) of 103 communities in China had a mean sodium intake greater than 5 g/day, whereas in other countries 224 (84%) of 266 communities had a mean intake of 3-5 g/day. Overall, mean systolic BP increased by 2·86 mm Hg per 1 g increase in mean sodium intake, but positive associations were only seen among the communities in the highest tertile of sodium intake (p<0·0001 for heterogeneity). The association between mean sodium intake and major cardiovascular events showed significant deviations from linearity (p=0·043) due to a significant inverse association in the lowest tertile of sodium intake (lowest tertile <4·43 g/day, mean intake 4·04 g/day, range 3·42-4·43; change -1·00 events per 1000 years, 95% CI -2·00 to -0·01, p=0·0497), no association in the middle tertile (middle tertile 4·43-5·08 g/day, mean intake 4·70 g/day, 4·44-5.05; change 0·24 events per 1000 years, -2·12 to 2·61, p=0·8391), and a positive but non-significant association in the highest tertile (highest tertile >5·08 g/day, mean intake 5·75 g/day, >5·08-7·49; change 0·37 events per 1000 years, -0·03 to 0·78, p=0·0712). A strong association was seen with stroke in China (mean sodium intake 5·58 g/day, 0·42 events per 1000 years, 95% CI 0·16 to 0·67, p=0·0020) compared with in other countries (4·49 g/day, -0·26 events, -0·46 to -0·06, p=0·0124; p<0·0001 for heterogeneity). All major cardiovascular outcomes decreased with increasing potassium intake in all countries.
INTERPRETATION:
Sodium intake was associated with cardiovascular disease and strokes only in communities where mean intake was greater than 5 g/day. A strategy of sodium reduction in these communities and countries but not in others might be appropriate.

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A healthy lifestyle attenuates the effect of polypharmacy on total and cardiovascular mortality: a national prospective cohort study.
Martinez-Gomez D, Guallar-Castillon P, Higueras-Fresnillo S, Banegas JR, Sadarangani KP, Rodriguez-Artalejo F.
Sci Rep. 2018 Aug 22;8(1):12615. doi: 10.1038/s41598-018-30840-9.
PMID: 30135569
Abstract
This work examines whether the increased all-cause and cardiovascular disease (CVD) mortality associated with polypharmacy could be offset by a healthy lifestyle. We included a prospective cohort of 3,925 individuals representative of the Spanish population aged ≥60 years, who were recruited in 2000-2001 and followed up through 2014. Polypharmacy was defined as treatment with ≥5 medications. The following lifestyle behaviors were considered healthy: not smoking, eating a healthy diet, being physically active, moderate alcohol consumption, low sitting time, and adequate sleep duration. Individuals were classified into three lifestyle categories s: unfavorable (0-2), intermediate (3-4) favorable (5-6). Over a median 13.8-y follow-up, 1,822 all-cause and 675 CVD deaths occurred. Among individuals with polypharmacy, intermediate and favorable lifestyles were associated with an all-cause mortality reduction (95% confidence interval [CI]) of 47% (34-58%) and 54% (37-66%), respectively; 37% (9-56%) and 60% (33-76%) for CVD death, respectively. The theoretical adjusted hazard ratio (95%CI) associated with replacing 1 medication with 1 healthy lifestyle behavior was 0.73 (0.66-0.81) for all-cause death and 0.69 (0.59-0.82) for CVD death. The theoretical adjusted hazard ratio (95%CI) for all-cause and CVD mortality associated with simply reducing 1 medication was 0.88 (0.83-0.94) and 0.83 (0.76-0.91), respectively. Hence, adherence to a healthy lifestyle behavior can reduce mortality risk associated with polypharmacy in older adults.

Soy isoflavone intake and bladder cancer risk in Japan: From the Takayama study.
Wada K, Tsuji M, Tamura T, Konishi K, Goto Y, Mizuta F, Koda S, Uji T, Hori A, Tanabashi S, Matsushita S, Tokimitsu N, Nagata C.
Cancer Epidemiol Biomarkers Prev. 2018 Aug 21. pii: cebp.0283.2018. doi: 10.1158/1055-9965.EPI-18-0283. [Epub ahead of print]
PMID: 30131436
Abstract
BACKGROUND:
There is growing evidence suggesting that soy isoflavones play a protective role in the development of cancer. However, few epidemiological studies have investigated the association between soy isoflavone intake and bladder cancer.
METHODS:
We evaluated the associations of soy and isoflavone intakes with bladder cancer incidence in a population-based prospective study in Japan. Subjects were 14,233 men and 16,584 women aged 35 years or older in September 1992. Soy and isoflavone intakes were assessed via a validated food-frequency questionnaire, while controlling for total energy intake. Cancer incidence was mainly confirmed through regional population-based cancer registries. Bladder cancer was defined as code C67 according to the International Classification of Diseases and Health Related Problems, 10th Revision.
RESULTS:
During mean follow-up of 13.6 years, 120 men and 41 women had developed bladder cancer. After adjustments for multiple confounders, compared with the lowest quartile of soy food intake, the estimated hazard ratios for the second, third, and highest quartiles of soy food intake were 0.74, 0.52, and 0.55, respectively, in men (P-trend: 0.023). The corresponding values were 0.60, 0.75, and 0.64, respectively, in women (P-trend: 0.43). Similar inverse associations were observed between isoflavone intake and bladder cancer risk.
CONCLUSIONS:
A significant decreased risk of bladder cancer was observed among men who had higher intakes of total soy and isoflavones.
IMPACT:
Our finding on the potential benefit of consuming soy foods against bladder cancer is intriguing, and warrants further studies.

Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data.
O'Neill D, Britton A, Hannah MK, Goldberg M, Kuh D, Khaw KT, Bell S.
BMC Med. 2018 Aug 22;16(1):124. doi: 10.1186/s12916-018-1123-6.
PMID: 30131059 Free Article
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1123-6
https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-018-1123-6
Abstract
BACKGROUND:
Studies have shown that alcohol intake trajectories differ in their associations with biomarkers of cardiovascular functioning, but it remains unclear if they also differ in their relationship to actual coronary heart disease (CHD) incidence. Using multiple longitudinal cohort studies, we evaluated the association between long-term alcohol consumption trajectories and CHD.
METHODS:
Data were drawn from six cohorts (five British and one French). The combined analytic sample comprised 35,132 individuals (62.1% male; individual cohorts ranging from 869 to 14,247 participants) of whom 4.9% experienced an incident (fatal or non-fatal) CHD event. Alcohol intake across three assessment periods of each cohort was used to determine participants' intake trajectories over approximately 10 years. Time to onset for (i) incident CHD and (ii) fatal CHD was established using surveys and linked medical record data. A meta-analysis of individual participant data was employed to estimate the intake trajectories' association with CHD onset, adjusting for demographic and clinical characteristics.
RESULTS:
Compared to consistently moderate drinkers (males: 1-168 g ethanol/week; females: 1-112 g ethanol/week), inconsistently moderate drinkers had a significantly greater risk of incident CHD [hazard ratio (HR) = 1.18, 95% confidence interval (CI) = 1.02-1.37]. An elevated risk of incident CHD was also found for former drinkers (HR = 1.31, 95% CI = 1.13-1.52) and consistent non-drinkers (HR = 1.47, 95% CI = 1.21-1.78), although, after sex stratification, the latter effect was only evident for females. When examining fatal CHD outcomes alone, only former drinkers had a significantly elevated risk, though hazard ratios for consistent non-drinkers were near identical. No evidence of elevated CHD risk was found for consistently heavy drinkers, and a weak association with fatal CHD for inconsistently heavy drinkers was attenuated following adjustment for confounding factors.
CONCLUSIONS:
Using prospectively recorded alcohol data, this study has shown how instability in drinking behaviours over time is associated with risk of CHD. As well as individuals who abstain from drinking (long term or more recently), those who are inconsistently moderate in their alcohol intake have a higher risk of experiencing CHD. This finding suggests that policies and interventions specifically encouraging consistency in adherence to lower-risk drinking guidelines could have public health benefits in reducing the population burden of CHD. The absence of an effect amongst heavy drinkers should be interpreted with caution given the known wider health risks associated with such intake.
KEYWORDS:
Alcohol; Coronary heart disease; IPD meta-analysis; Longitudinal design

Changes in Neighborhood Socioeconomic Deprivation and Mortality in US Adults.
Xiao Q, Berrigan D, Powell-Wiley TM, Matthews CE.
Am J Epidemiol. 2018 Aug 22. doi: 10.1093/aje/kwy181. [Epub ahead of print]
PMID: 30137194
Abstract
Low neighborhood socioeconomic status has been linked to adverse health outcomes. However, it is unclear whether changing the neighborhood may influence health. We examined the 10-year change in neighborhood socioeconomic deprivation in relation to mortality rate among 288,555 participants (age 51-70) who enrolled in the NIH-AARP Diet and Health Study in 1995-1996 (baseline) and did not move during the study. Changes in neighborhood socioeconomic deprivation between 1990 and 2000 was measured by US Census data at the census tract level. All-cause, cardiovascular and cancer deaths were ascertained by annual linkage to the Social Security Administration Death Master File between 2000 and 2011. Overall, our results suggested that improvement in neighborhood socioeconomic status was associated with lower mortality rate, while deterioration was associated with higher mortality rate. More specially, a 30 percentile points reduction in neighborhood deprivation among more deprived neighborhoods was associated with 11% and 19% reduction in total mortality rate in men and women respectively. On the other hand, a 30 points increase in neighborhood deprivation in less deprived neighborhoods was associated with a 11% increase in mortality rate in men. Our findings support a longitudinal association between changing neighborhood conditions and mortality.

Body composition measurements and risk of hematological malignancies: A population-based cohort study during 20 years of follow-up.
Hagström H, Andreasson A, Carlsson AC, Jerkeman M, Carlsten M.
PLoS One. 2018 Aug 23;13(8):e0202651. doi: 10.1371/journal.pone.0202651. eCollection 2018.
PMID: 30138405
Abstract
High body mass index (BMI) is associated with development of hematological malignancies (HMs). However, although BMI is a well-established measurement of excess weight, it does not fully reflect body composition and can sometimes misclassify individuals. This study aimed at investigating what body composition measurements had highest association with development of HM. Body composition measurements on 27,557 individuals recorded by healthcare professionals as part of the Malmö Diet and Cancer study conducted in Sweden between 1991-1996 were matched with data from national registers on cancer incidence and causes of death. Cox regression models adjusted for age and sex were used to test the association between one standard deviation increments in body composition measurements and risk of HM. During a median follow-up of 20 years, 564 persons developed an HM. Several body composition measurements were associated with risk of developing an HM, but the strongest association was found for multiple myeloma (MM). Waist circumference (HR 1.31, p = 0.04) and waist-hip ratio (HR 1.61, p = 0.05) had higher risk estimates than BMI (HR 1.18, p = 0.07) for MM. In conclusion, our study shows that measurements of abdominal adiposity better predict the risk of developing HM, particularly MM, compared to BMI.

Rich man, poor man: The high-income guy can expect to live 8 years longer
For Canadian women, the difference between rich and poor is much less, just 3 years
Susan Noakes · CBC News · Posted: Aug 23, 2018
http://www.cbc.ca/news/business/longevity-gap-life-expectancy-canada-cd-howe-1.4795121
>>>>>>>>>>>>>>>>>>>>>
August 23, 2018
RETIREMENT SAVING AND INCOME
Rich Man, Poor Man: The Policy Implications of
Canadians Living Longer
by
Kevin Milligan and Tammy Schirle
https://cdhowe.org/sites/default/files/attachments/research_papers/mixed/Rich Man%2C Poor Man - The Policy Implications of Canadians Living Longer.pdf

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Enhancing and Extending Biological Performance and Resilience.
Leak RK, Calabrese EJ, Kozumbo WJ, Gidday JM, Johnson TE, Mitchell JR, Ozaki CK, Wetzker R, Bast A, Belz RG, Bøtker HE, Koch S, Mattson MP, Simon RP, Jirtle RL, Andersen ME.
Dose Response. 2018 Aug 15;16(3):1559325818784501. doi: 10.1177/1559325818784501. eCollection 2018 Jul-Sep. Review.
PMID: 30140178
http://journals.sagepub.com/doi/10.1177/1559325818784501
Abstract
Human performance, endurance, and resilience have biological limits that are genetically and epigenetically predetermined but perhaps not yet optimized. There are few systematic, rigorous studies on how to raise these limits and reach the true maxima. Achieving this goal might accelerate translation of the theoretical concepts of conditioning, hormesis, and stress adaptation into technological advancements. In 2017, an Air Force-sponsored conference was held at the University of Massachusetts for discipline experts to display data showing that the amplitude and duration of biological performance might be magnified and to discuss whether there might be harmful consequences of exceeding typical maxima. The charge of the workshop was "to examine and discuss and, if possible, recommend approaches to control and exploit endogenous defense mechanisms to enhance the structure and function of biological tissues." The goal of this white paper is to fulfill and extend this workshop charge. First, a few of the established methods to exploit endogenous defense mechanisms are described, based on workshop presentations. Next, the white paper accomplishes the following goals to provide: (1) synthesis and critical analysis of concepts across some of the published work on endogenous defenses, (2) generation of new ideas on augmenting biological performance and resilience, and (3) specific recommendations for researchers to not only examine a wider range of stimulus doses but to also systematically modify the temporal dimension in stimulus inputs (timing, number, frequency, and duration of exposures) and in measurement outputs (interval until assay end point, and lifespan). Thus, a path forward is proposed for researchers hoping to optimize protocols that support human health and longevity, whether in civilians, soldiers, athletes, or the elderly patients. The long-term goal of these specific recommendations is to accelerate the discovery of practical methods to conquer what were once considered intractable constraints on performance maxima.
KEYWORDS:
J-shaped; U-shaped; adaptation; biphasic; caloric restriction; conditioning; dietary restriction; dose–response; endurance; epigenetics; fitness; hormesis; preconditioning; stress; tolerance

A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults.
Stote KS, Baer DJ, Spears K, Paul DR, Harris GK, Rumpler WV, Strycula P, Najjar SS, Ferrucci L, Ingram DK, Longo DL, Mattson MP.
Am J Clin Nutr. 2007 Apr;85(4):981-8.
PMID: 17413096 Free PMC Article
https://watermark.silverchair.com/znu00407000981.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAawwggGoBgkqhkiG9w0BBwagggGZMIIBlQIBADCCAY4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMBfZCIQwbz55ocDxZAgEQgIIBXxKHRI7YPWe15Dnnt7-eDeHyjTObI46Ns29GpbgeByXE4O2eChPPPYa3q3VLTVskTXTiUC6WINsQtwqlqHUqX7m4F-rUqEGaFre1UsS06lBBbOIsqM2r-HP98gxAOEbQlm9U0n_A2kdKlSeLLpXQt_43JSAy7OTIToZ1Ky0SSbbwmUzkk-SkahbAozxoFQ-kmDknr-WB3OVezdk9wZspqFc_msHfrJdltO8hWDGVVF56RZ2y9GgFO21YpYqhUhJWzndgynd8sDfPWE1zgsicDQazAH2QtGvKV3apJIrTn9qm_-vUsn467MaKVmXFhJTxflLcEf_gsNvN8ZPaev8enEG1Zdy8dkd14ptRTtn07hdoNL-pKxDYudOH9yGtewdt59b0ekWeBVBH3VFjegmx1odo0Knu4OmpwXTKX9eBkMmxwyqvGokVHkjPXyCC17wbU5HFAH_UIN6chj0oE7dlZg
Abstract
BACKGROUND:
Although consumption of 3 meals/d is the most common pattern of eating in industrialized countries, a scientific rationale for this meal frequency with respect to optimal health is lacking. A diet with less meal frequency can improve the health and extend the lifespan of laboratory animals, but its effect on humans has never been tested.
OBJECTIVE:
A pilot study was conducted to establish the effects of a reduced-meal-frequency diet on health indicators in healthy, normal-weight adults.
DESIGN:
The study was a randomized crossover design with two 8-wk treatment periods. During the treatment periods, subjects consumed all of the calories needed for weight maintenance in either 3 meals/d or 1 meal/d.
RESULTS:
Subjects who completed the study maintained their body weight within 2 kg of their initial weight throughout the 6-mo period. There were no significant effects of meal frequency on heart rate, body temperature, or most of the blood variables measured. However, when consuming 1 meal/d, subjects had a significant increase in hunger; a significant modification of body composition, including reductions in fat mass; significant increases in blood pressure and in total, LDL-, and HDL-cholesterol concentrations; and a significant decrease in concentrations of cortisol.
CONCLUSIONS:
Normal-weight subjects are able to comply with a 1 meal/d diet. When meal frequency is decreased without a reduction in overall calorie intake, modest changes occur in body composition, some cardiovascular disease risk factors, and hematologic variables. Diurnal variations may affect outcomes.
>>>>>>>>>>>>>>>>>>>>>
A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults.
Kelly CJ.
Am J Clin Nutr. 2007 Oct;86(4):1254-5. No abstract available.
PMID: 17921414
https://academic.oup.com/ajcn/article/86/4/1254/4649665
Dear Sir:
Studies in rodents have shown a marked increase in lifespan and disease resistance in animals subjected to intermittent fasting (1, 2). The suggestion that humans may respond similarly to a reduced meal frequency raises several important questions. Is reduced meal frequency feasible in humans? Does reduced meal frequency confer health benefits independent of calorie restriction? Are there alternative approaches by which to study the relation between meal frequency and longevity? The recent article in the Journal by Stote et al (3) provides insight into this inadequately studied aspect of human nutrition (4). With respect to the first question, the trial by Stote et al (3) and that by Heilbronn et al (5) showed that compliance with once-a-day and alternate-day feeding is feasible for humans participating in controlled trials. However, greater subjective ratings of hunger indicate that compliance is unlikely in free-living persons. In addition, restricting consumption to once a day may compromise diet quality. In the trial by Stote et al, subjects consuming one meal a day “reported extreme fullness after the meal and had difficulty finishing their food in the allotted time.” This occurred despite the selection of energy-dense foods and a fiber intake of only 7.4 g/1000 kcal, which is below the current adequate intake of 14 g/1000 kcal (6). Foods with low energy density, such as fresh fruit, vegetables, water-rich whole grains, and legumes, are associated with high diet quality (7). Adherence to a diet restricted to one meal a day would preclude frequent selection of such foods because of their bulk. A direct comparison between the study by Stote et al and those studies performed in animals is complicated by methodologic differences. However, the absence of overlap in measured biomarkers suggests that reduced meal frequency without calorie restriction in humans is unlikely to achieve the extension in lifespan seen in animal models.
As discussed by Stote et al, Muslims who fast during Ramadan exhibit physiologic adaptations to the consumption of 2 meals/d. A different 2 meals/d pattern is followed by some Seventh-day Adventists (8). The proportion of Seventh-day Adventists who adhere to a 2 meals/d pattern is lower than that of Muslims during Ramadan. Yet, among Seventh-day Adventists, the 2 meals/d pattern typically is chronic, and sometimes lifelong, which would allow sufficient time to achieve stable changes in physiology. The timing of meals represents another distinction between these 2 religious groups. During Ramadan, Muslims eat before dawn and after dusk. Seventh-day Adventists following a 2 meals/d plan typically consume their final meal in the afternoon. This pattern results in a longer period between dinner and breakfast, which may be biologically important (9). Seventh-day Adventists had a greater life expectancy than did other white Californians (10), which has been attributed to low smoking rates, their emphasis on the consumption of a plant-based diet, and several other lifestyle factors. However, the relation between reduced meal frequency and longevity among Seventh-day Adventists has never been studied. Prospective or cross-sectional studies of Seventh-day Adventists present a valuable opportunity to clarify the relation between meal frequency and longevity in humans.

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Long-term neurological outcomes in patients aged over 90 years who are admitted to the intensive care unit following cardiac arrest.
Roedl K, Jarczak D, Becker S, Fuhrmann V, Kluge S, Müller J.
Resuscitation. 2018 Aug 22. pii: S0300-9572(18)30768-8. doi: 10.1016/j.resuscitation.2018.08.020. [Epub ahead of print]
PMID: 30144464
Abstract
BACKGROUND:
The number of cardiac arrests (CA) in the group of very elderly patients (≥ 90 years) is expected to increase markedly due to the world`s rapidly ageing population. However, only little is known about long term outcome, CA- and intensive care unit (ICU) characteristics of patient's ≥ 90 years (nonagenarians) suffering from CA.
METHODS:
This single-center retrospective study included all adult patients ≥ 90 years after CA and return of spontaneous circulation (ROSC) which were treated at our ICU between January 1st 2008 and September 15th 2016. Patients were followed at least 1-Year after ICU discharge for assessment of survival and neurological outcome. Aim of the study was to evaluate CA- and patients characteristics, as well as ICU- and neurological outcome after CA in patient's ≥ 90 years.
RESULTS:
657 patients ≥ 90 years were treated at our ICU during the study period, of these we could identify 48 patients with CA and successful resuscitation. 27 (56%) were female and the median age was 91.7 (90.7 - 92.6) years. 41 (85%) patient suffered from in-hospital CA. Cardiac events leading to CA were observed in 19 (40%) patients. Initial rhythm was shockable (VT/VF) in 12 (25%) patients and time to ROSC was median 4 (1.6 - 9.5) minutes. Patients after CA who survived the ICU stay had significantly lower SAPS II score (44 (36 - 55) vs. 58 (46.5 - 75.5), p < 0.05), lower maximum lactate (2.8 (1.9 - 4.3) mmol/l vs. 6.2 (4 - 9) mmol/l, p < 0.001) and higher pH (7.29 (7.26 - 7.38) vs. 7.23 (7.12 - 7.32), p < 0.05) on admission compared to patients with CA who did not survive the ICU stay. Overall, after CA, 39 (81%) patients needed mechanical ventilation, 44 (92%) received catecholamine support, 17 (35%) received red blood cell transfusion and 4 (8%) received renal replacement therapy. Mechanical ventilation and red blood cell transfusion was significantly more common in ICU non-survivors (both p < 0.05). 19 (46%) patients survived the ICU-stay, of these 86% had favourable neurological outcome (CPC I/II) at ICU discharge. One year survival rate was 23% (n = 11), of these 55% (n = 6) had favorable neurological outcome.
CONCLUSIONS:
46% of successfully resuscitated nonagenarians survived the ICU stay, the majority with favourable neurological outcome at ICU discharge. Resuscitation and post-CA care, in the highly selected group of very elderly patients (≥ 90 years), seems to be justified.
KEYWORDS:
Cardiac arrest; ICU; Mortality; Nonagenarian; Very elderly

Whole-body vibration training and bone health in postmenopausal women: A systematic review and meta-analysis.
Marín-Cascales E, Alcaraz PE, Ramos-Campo DJ, Martinez-Rodriguez A, Chung LH, Rubio-Arias JÁ.
Medicine (Baltimore). 2018 Aug;97(34):e11918. doi: 10.1097/MD.0000000000011918.
PMID: 30142802
Abstract
BACKGROUND:
The aims of the present systematic review and meta-analysis were to evaluate published, randomized controlled trials that investigate the effects on whole-body vibration (WBV) training on total, femoral neck, and lumbar spine bone mineral density (BMD) in postmenopausal women, and identify the potential moderating factors explaining the adaptations to such training.
METHODS:
From a search of electronic databases (PubMed, Web of Science, and Cochrane) up until September 2017, a total 10 studies with 14 WBV groups met the inclusion criteria. Three different authors tabulated, independently, the selected indices in identical predetermined forms. The methodological quality of all studies was evaluated according to the modified PEDro scale. For each trial, differences within arms were calculated as mean differences (MDs) and their 95% confidence intervals between pre- and postintervention values. The effects on bone mass between exercise and control groups were also expressed as MDs. Both analyses were performed in the total sample and in a specific class of postmenopausal women younger than 65 years of age (excluding older women).
RESULTS:
The BMD of 462 postmenopausal women who performed WBV or control protocol was evaluated. Significant pre-post improvements in BMD of the lumbar spine were identified following WBV protocols (P = .03). Significant differences in femoral neck BMD (P = .03) were also found between intervention and control groups when analyzing studies that included postmenopausal women younger than 65 years.
CONCLUSIONS:
WBV is an effective method to improve lumbar spine BMD in postmenopausal and older women and to enhance femoral neck BMD in postmenopausal women younger than 65 years.

Sodium Reduction, miRNA Profiling and CVD Risk in Untreated Hypertensives: a Randomized, Double-Blind, Placebo-Controlled Trial.
Chen L, He FJ, Dong Y, Huang Y, Harshfield GA, Zhu H.
Sci Rep. 2018 Aug 24;8(1):12729. doi: 10.1038/s41598-018-31139-5.
PMID: 30143705
https://www.nature.com/articles/s41598-018-31139-5
Abstract
Sodium reduction decreases blood pressure (BP) and cardiovascular mortality. However, the underlying molecular mechanisms are not well understood. We tested the hypothesis that reduction of sodium intake would change miRNA expression in hypertensive patients, and those changes would be associated with improved cardiovascular phenotypes. A whole genome RNA sequencing was performed in paired serum samples collected at the end of usual sodium intake and reduced sodium intake periods from 10 (age 56.8 ± 8.9) untreated black male hypertensives, selected from a randomized crossover trial of sodium reduction as the discovery cohort. Validation was carried out by the PCR Serum/Plasma Focus panel profiling in paired samples in all 64 (50% males, age 50.2 ± 9.5) untreated black hypertensives from the same trial. Fifteen respondent miRNAs were identified in the discovery stage. miR-143-3p was replicated. Sodium reduction up-regulated miR-143-3p. The increase in miR-143-3p was associated with the reduction of BP and arterial stiffness and the increase in skin capillary density. In conclusion, dietary sodium reduction alters circulating miRNA expressions, and those miRNA changes are associated with reduced BP and improved arterial compliance in untreated black hypertensives, suggesting that miRNA regulation may be one of the underlying mechanisms that dietary sodium regulates cardiovascular health.

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Potato consumption and risk of type 2 diabetes: A dose-response meta-analysis of cohort studies.
Bidel Z, Teymoori F, Davari SJ, Nazarzadeh M.
Clin Nutr ESPEN. 2018 Oct;27:86-91. doi: 10.1016/j.clnesp.2018.06.004. Epub 2018 Jun 28.
PMID: 30144898
Abstract
BACKGROUND & AIMS:
High potato intake has been suggested as a risk factor for the development of type 2 diabetes. We aimed to investigate the association between potato consumption and risk of type 2 diabetes.
METHODS:
A systematic review was conducted on PubMed and Embase from the database commencement until September 2017 (updated by June 2018) following the MOOSE guidelines. The random effect model dose-response meta-analysis method of Greenland and Longneck was used to estimate the maximally adjusted log hazard ratio (HR) for a unit (serving per day) increment of potato consumption. A restricted cubic spline model with three knots was used to evaluate the potential non-linear relationship.
RESULTS:
A total of 3544 citations were retrieved from the databases, of which six prospective cohort studies including 4545230 person-year of follow-up and 17,758 diabetes cases met the inclusion criteria. The pooled dose-response HR per an increment of 1 serving/day of total potato consumption was 1.20 (95% CI 1.13 to 1.127, P < 0.001, I2 = 27.1%, P for heterogeneity = 0.23) both in men and women. The larger risk were observed for 2 serving/day (HR 1.44, 95% CI 1.28 to 1.63) and 3 serving/day (HR 1.74, 95% CI 1.45 to 2.09). We found significant evidence of a non-linear association between total potato consumption and risk of type 2 diabetes (X2 = 17.5, P for linearity < 0.001).
CONCLUSION:
Long-term high consumption of potato (each serving a day increase) may be strongly associated with increased risk of diabetes. These findings suggest that diet-health policy may be of importance in the prevention of diabetes.
KEYWORDS:
Diabetes mellitus; Meta-analysis; Potato; Risk factor

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Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
GBD 2016 Alcohol Collaborators.
Lancet. 2018 Aug 23. pii: S0140-6736(18)31310-2. doi: 10.1016/S0140-6736(18)31310-2. [Epub ahead of print]
PMID: 30146330
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext
https://www.thelancet.com/action/showPdf?pii=S0140-6736(18)31310-2
Abstract
BACKGROUND:
Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.
METHODS:
Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.
FINDINGS:
Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week.
INTERPRETATION:
Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

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Body Composition, IGF1 Status, and Physical Functionality in Nonagenarians: Implications for Osteosarcopenia.
Poggiogalle E, Cherry KE, Su LJ, Kim S, Myers L, Welsh DA, Jazwinski SM, Ravussin E.
J Am Med Dir Assoc. 2018 Aug 24. pii: S1525-8610(18)30389-X. doi: 10.1016/j.jamda.2018.07.007. [Epub ahead of print]
PMID: 30149984
Abstract
OBJECTIVES:
Body composition alterations occur during aging. The purpose of the present analysis was to explore the functional consequences of the overlap of sarcopenia and osteoporosis, and the potential role of insulin-like growth factor 1 (IGF1) in their development in the oldest old.
SETTING AND PARTICIPANTS:
Eighty-seven nonagenarians from the Louisiana Healthy Aging Study were included.
MEASURES:
The definition of sarcopenia was based on appendicular lean mass (ALM). Osteoporosis was diagnosed based on bone mineral density (BMD) T score. Four phenotypes were compared: (1) healthy body composition, that is, nonosteoporotic nonsarcopenic (CO, control group), (2) osteoporotic (O, low BMD T score), (3) sarcopenic (S, low ALM), and (4) osteosarcopenic (OS, low BMD T score and low ALM). Sex- and age-specific IGF1-Standard Deviation Scores (SDS) were calculated. The Continuous Scale-Physical Functional Performance (CS-PFP) test was performed.
RESULTS:
In OS men, IGF1-SDS values (-0.61 ±0.37 vs -0.04 ± 0.52, P = .02) were lower than those in CO males (control group), whereas IGF1-SDS were similar in the 4 body composition phenotypes in women. In men only, ALM was positively associated with IGF1-SDS values (P = .01) independent of age and C-reactive protein concentration. Regarding bone health, we found no association between IGF1-SDS values and BMD. IGF1-SDS was not associated with functional performance (CS-PFP) in men and women.
CONCLUSIONS/IMPLICATIONS:
IGF1 sensitivity in skeletal muscle and bone may differ by sex in the oldest old. IGF1 status did not appear to affect physical functionality. Determinants and clinical and functional characteristics of osteosarcopenia need to be further investigated in order to define conclusive diagnostic criteria.
KEYWORDS:
Osteosarcopenia; insulin-like growth factor 1; nonagenarians; physical functionality

Whole body protein anabolism in COPD patients and healthy older adults is not enhanced by adding either carbohydrates or leucine to a serving of protein.
Jonker R, Deutz NEP, Schols AMWJ, Veley EA, Harrykissoon R, Zachria AJ, Engelen MPKJ.
Clin Nutr. 2018 Aug 16. pii: S0261-5614(18)31348-7. doi: 10.1016/j.clnu.2018.08.006. [Epub ahead of print]
PMID: 30150004
Abstract
BACKGROUND & AIMS:
Carbohydrates (CHO) and leucine (LEU) both have insulinotropic properties, and could therefore enhance the protein anabolic capacity of dietary proteins, which are important nutrients in preventing muscle loss in patients with Chronic Obstructive Pulmonary Disease (COPD). LEU is also known to activate protein anabolic signaling pathways independent of insulin. Based on our previous findings in COPD, we hypothesized that whole body protein anabolism is enhanced to a comparable extent by the separate and combined co-ingestion of CHO and LEU with protein.
METHODS:
To disentangle the protein anabolic effects of CHO and/or free LEU when co-ingested with a high-quality protein, we studied 10 patients with moderate to very severe COPD and dyspnea (GOLD: II-IV, mMRC dyspnea scale ≥ 2), at risk for muscle loss, and 10 healthy age- and gender-matched controls. On four occasions, in a single-blind randomized crossover design, each subject ingested a drink containing 0.6 g/kg fat-free mass (ffm) hydrolyzed casein protein with, a) no add-ons (protein), b) 0.3 g/kg ffm CHO (protein + CHO), c) 0.095 g/kg ffm leucine (protein + LEU), d) both add-ons (protein + CHO + LEU). Whole body protein breakdown (PB), protein synthesis (PS), and net protein balance (= PS - PB) were measured by IV primed and continuous infusion of L-[ring-2H5]-phenylalanine and L-[13C9,15N]-tyrosine. L-[15N]-phenylalanine was added to the protein drinks to measure splanchnic extraction.
RESULTS:
In both groups, whole body PS, PB and net protein balance responses were comparable between the four protein drinks, despite higher postprandial plasma LEU concentrations for the LEU supplemented drinks (P < 0.05), and higher insulin concentrations for the CHO supplemented drinks as compared to the protein only drink (P < 0.05).
CONCLUSIONS:
Adding CHO and/or LEU to a serving of high-quality protein does not further augment whole body protein anabolism in dyspneic COPD patients at risk for muscle loss or healthy older adults.
KEYWORDS:
Anabolic response; COPD; Carbohydrate; Coingestion; Leucine

A framework for selection of blood-based biomarkers for geroscience-guided clinical trials: report from the TAME Biomarkers Workgroup.
Justice JN, Ferrucci L, Newman AB, Aroda VR, Bahnson JL, Divers J, Espeland MA, Marcovina S, Pollak MN, Kritchevsky SB, Barzilai N, Kuchel GA.
Geroscience. 2018 Aug 27. doi: 10.1007/s11357-018-0042-y. [Epub ahead of print] Review.
PMID: 30151729
Abstract
Recent advances indicate that biological aging is a potentially modifiable driver of late-life function and chronic disease and have led to the development of geroscience-guided therapeutic trials such as TAME (Targeting Aging with MEtformin). TAME is a proposed randomized clinical trial using metformin to affect molecular aging pathways to slow the incidence of age-related multi-morbidity and functional decline. In trials focusing on clinical end-points (e.g., disease diagnosis or death), biomarkers help show that the intervention is affecting the underlying aging biology before sufficient clinical events have accumulated to test the study hypothesis. Since there is no standard set of biomarkers of aging for clinical trials, an expert panel was convened and comprehensive literature reviews conducted to identify 258 initial candidate biomarkers of aging and age-related disease. Next selection criteria were derived and applied to refine this set emphasizing: (1) measurement reliability and feasibility; (2) relevance to aging; (3) robust and consistent ability to predict all-cause mortality, clinical and functional outcomes; and (4) responsiveness to intervention. Application of these selection criteria to the current literature resulted in a short list of blood-based biomarkers proposed for TAME: IL-6, TNFα-receptor I or II, CRP, GDF15, insulin, IGF1, cystatin C, NT-proBNP, and hemoglobin A1c. The present report provides a conceptual framework for the selection of blood-based biomarkers for use in geroscience-guided clinical trials. This work also revealed the scarcity of well-vetted biomarkers for human studies that reflect underlying biologic aging hallmarks, and the need to leverage proposed trials for future biomarker discovery and validation.
KEYWORDS:
Aging; Biomarkers; Epidemiology; Inflammation; Metformin; Mortality; Randomized controlled trial

Does Helicobacter pylori eradication therapy to prevent gastric cancer increase all-cause mortality?
Gyawali B, Kesselheim AS, D'Andrea E.
Int J Cancer. 2018 Aug 28. doi: 10.1002/ijc.31772. [Epub ahead of print]
PMID: 30152520
Abstract
Infection with Helicobacter pylori has been linked to 78% of gastric cancer cases, prompting the International Agency for Research on Cancer to classify H. pylori as a Group 1 carcinogen. Thus, H. pylori eradication therapy is recommended to prevent gastric cancer. In 2014, a meta-analysis of randomized controlled trials (RCTs) found a substantially reduced risk of gastric cancer but also a non-significant 9% increase in the risk of all-cause mortality among patients randomized to eradication therapy (Risk Ratio 1.09, 95% CI 0.86-1.38). A more recent RCT also demonstrated a reduced risk of gastric cancer, but again showed a non-significant increased risk of all-cause mortality among patients randomized to eradication therapy (Hazard Ratio 1.95, 95% CI, 0.72 to 5.27; P = 0.19). The possibility that there could also be an association with an increased risk of all-cause mortality is an important public health concern. Thus, we performed an updated systematic review and meta-analysis of RCTs evaluating H. pylori eradication therapy to evaluate the risk of all-cause mortality. Our updated meta-analysis still did not find a statistically significant increase in the risk of all-cause mortality with H. pylori eradication therapy, which should be reassuring for patients and physicians. Since the pooled RR remained over 1, we conclude that continued real-world surveillance of patients treated with eradication therapy as well as longer-term follow up of these RCTs are necessary to further confirm that no such mortality risk exists in real-world.

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The meta-analysis suggests that H. Pylori eradication might not increase all-cause mortality.  But the two studies present non-statistically insignificant data that suggests the opposite.

Probably, the "eradication" is by using antibiotics.  This of course messes up gut microbiota, especially for those on a poor diet.  So it's possible that there really might be more risk than benefi, except in patients who have other indicators of an especial risk of gastric cancer.

  --  Saul

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Methionine Restriction Extends Lifespan in Progeroid Mice and Alters Lipid and Bile Acid Metabolism.
Bárcena C, Quirós PM, Durand S, Mayoral P, Rodríguez F, Caravia XM, Mariño G, Garabaya C, Fernández-García MT, Kroemer G, Freije JMP, López-Otín C.
Cell Rep. 2018 Aug 28;24(9):2392-2403. doi: 10.1016/j.celrep.2018.07.089.
PMID: 30157432
https://linkinghub.elsevier.com/retrieve/pii/S2211124718312221
Abstract
Dietary intervention constitutes a feasible approach for modulating metabolism and improving the health span and lifespan. Methionine restriction (MR) delays the appearance of age-related diseases and increases longevity in normal mice. However, the effect of MR on premature aging remains to be elucidated. Here, we describe that MR extends lifespan in two different mouse models of Hutchinson-Gilford progeria syndrome (HGPS) by reversing the transcriptome alterations in inflammation and DNA-damage response genes present in this condition. Further, MR improves the lipid profile and changes bile acid levels and conjugation, both in wild-type and in progeroid mice. Notably, treatment with cholic acid improves the health span and lifespan in vivo. These results suggest the existence of a metabolic pathway involved in the longevity extension achieved by MR and support the possibility of dietary interventions for treating progeria.
KEYWORDS:
Hutchinson-Gilford progeria syndrome; aging; bile acids; caloric restriction; dietary intervention; methionine restriction

Aloe Vera is Effective and Safe in Short-term Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis.
Hong SW, Chun J, Park S, Lee HJ, Im JP, Kim JS.
J Neurogastroenterol Motil. 2018 Aug 29. doi: 10.5056/jnm18077. [Epub ahead of print]
PMID: 30153721
Abstract
BACKGROUND/AIMS:
To evaluate the efficacy and safety of Aloe vera (AV) in patients with irritable bowel syndrome (IBS).
METHODS:
We searched the MEDLINE, EMBASE, and Cochrane databases for studies dated between 1st January 1960 and 30th December 2017. Eligible randomized controlled trials (RCTs) compared AV to placebo in patients with IBS. The primary outcome was standardized mean difference of the change in severity of IBS symptoms as measured by patient-rated scales. Secondary outcomes included response rate of IBS symptoms and adverse events. Heterogeneity among studies was assessed using Cochrane's Q and I2 statistics.
RESULTS:
Three RCTs with a total of 151 patients with IBS were included. The meta-analysis showed a significant difference for patients with AV compared to those with placebo regarding improvement in IBS symptom score (standardized mean difference, 0.41; 95% CI, 0.07-0.75; P = 0.020). Using intention-to-treat analysis, the AV patients showed significantly better response rates of IBS symptoms compared to placebo (pooled risk ratio, 1.69; 95% CI, 1.05-2.73; P = 0.030). No adverse events related with AV were found in included studies. There was no significant heterogeneity of effects across studies (P = 0.900; I2 = 0%).
CONCLUSIONS:
AV is effective and safe for the treatment of patients with IBS compared to placebo.
KEYWORDS:
Aloe; Irritable bowel syndrome; Meta-analysis; Review

Sleep duration and sleep disturbances in association with falls among the middle-aged and older adults in China: a population-based nationwide study.
Essien SK, Feng CX, Sun W, Farag M, Li L, Gao Y.
BMC Geriatr. 2018 Aug 28;18(1):196. doi: 10.1186/s12877-018-0889-x.
PMID: 30153791
https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-018-0889-x
Abstract
BACKGROUND:
Falls pose major health problems to the middle-aged and older adults and may potentially lead to various levels of injuries. Sleep duration and disturbances have been shown to be associated with falls in literature; however, studies of the joint and distinct effects of those sleep problems are still sparse. To fill this gap, we aimed to determine the association between sleep duration, sleep disturbances and falls among middle-aged and older adults in China controlling for psychosocial, lifestyle, socio-demographical factors and comorbidity.
METHODS:
Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) based on multi-stage sampling designs, with respondents aged 50 and older. Associations were evaluated by using multiple logistic regression adjusting for confounders and complex survey design. To further determine if the association of sleep duration/disturbance and falls depends on age groups, the study data were divided into two samples (age 50-64 vs. age 65+) and comparison was made between the two age groups.
RESULTS:
Of the 12,759 respondents, 2172 (17%) had falls within the last 2 years. Our findings indicated that the participants who had nighttime sleep duration ≤5 were more likely to report falls than those who had nighttime sleep duration ≥6 h; whereas no association between nighttime sleep duration > 8 h and falls. Participants having sleep disturbances 1-2 days, or 3-4 days, and 5-7 days per week were also more likely to report falls than those who had no sleep disturbance. The nap sleep duration was not significantly associated with falls. Although the combined sample found both sleep duration and sleep disturbance to be strongly associated with falls after adjusting for various confounders, sleep disturbance was not significantly related to falls among participants aged 65 + .
CONCLUSIONS:
Our study suggested that there is an independent association between falls and short sleep duration and disturbed sleep among middle-aged and older adults in China. Findings underscore the need for evidence-based prevention and interventions targeting sleep duration and disturbance among this study population.
KEYWORDS:
Falls; Middle-aged and older adults; Sleep disturbance; Sleep duration

Vegetable and fruit intake and injurious falls risk in older women: a prospective cohort study.
Sim M, Blekkenhorst LC, Lewis JR, Bondonno CP, Devine A, Zhu K, Woodman RJ, Prince RL, Hodgson JM.
Br J Nutr. 2018 Aug 29:1-10. doi: 10.1017/S0007114518002155. [Epub ahead of print]
PMID: 30153877
Abstract
The role of vegetable and fruit intake in reducing falls risk in elderly populations is uncertain. This study examined the associations of vegetable and fruit intake with falls-related hospitalisations in a prospective cohort study of elderly women (n 1429, ≥70 years), including effects on muscular function, which represented a potential causal pathway. Muscular function, measured using grip strength and timed-up-and-go (TUG), and vegetable and fruit intake, quantified using a validated FFQ, were assessed at baseline (1998). Incident falls-related hospitalisation over 14·5-year follow-up was captured by the Hospital Morbidity Data Collection, linked via the Western Australian Data Linkage System. Falls-related hospitalisation occurred in 568 (39·7 %) of women. In multivariable-adjusted models, falls-related hospitalisations were lower in participants consuming more vegetables (hazard ratio (HR) per 75 g serve: 0·90 (95 % CI 0·82, 0·99)), but not fruit intake (per 150 g serve: 1·03 (95 % CI 0·93, 1·14)). Only total cruciferous vegetable intake was inversely associated with falls-related hospitalisation (HR: per 20 g serve: 0·90 (95 % CI 0·83, 0·97)). Higher total vegetable intake was associated with lower odds for poor grip strength (OR: 0·87 (95 % CI 0·77, 0·97)) and slow TUG (OR: 0·88 (95 % CI 0·78, 0·99)). Including grip strength and TUG in the multivariable-adjusted model attenuated the association between total vegetable intake and falls-related hospitalisations. In conclusion, elderly women with higher total and cruciferous vegetable intake had lower injurious falls risk, which may be explained in a large part by better physical function. Falls reduction may be considered an additional benefit of higher vegetable intake in older women.
KEYWORDS:
HR hazard ratio; TUG timed-up-and go; Ageing; Epidemiology; Nutrition; Skeletal muscle

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Heterogeneity of thyroid function and impact of peripheral thyroxine deiodination in centenarians and semi-supercentenarians: association with functional status and mortality.
Ostan R, Monti D, Mari D, Arosio B, Gentilini D, Ferri E, Passarino G, De Rango F, D'Aquila P, Mariotti S, Pasquali R, Fanelli F, Bucci L, Franceschi C, Vitale G.
J Gerontol A Biol Sci Med Sci. 2018 Aug 25. doi: 10.1093/gerona/gly194. [Epub ahead of print]
PMID: 30165411
https://sci-hub.tw/https://academic.oup.com/biomedgerontology/advance-article-abstract/doi/10.1093/gerona/gly194/5079484?redirectedFrom=fulltext
Abstract
Thyroid hormones (FT3, FT4) and TSH were evaluated in a population of 672 well-characterized Italian subjects (age range: 52-113 years), including an unprecedented number of centenarians, semi-supercentenarians, as well as centenarian's offspring and age-matched elderly (CENT, 105+, CENTOFF and CTRL, respectively). The results show that FT3 level and FT3/FT4 ratio decrease while FT4 and TSH increase in an age-dependent manner. In CENT/105+, higher FT4 level and lower FT3/FT4 ratio are associated with an impaired functional status and an increased mortality. A cluster analysis identified three clusters of CENT/105+ based on their FT3, FT4 and TSH levels. Cluster3, characterized by lower FT3 and TSH and higher FT4, shows the worst health status and the shortest survival. Thus, the age-related changes of thyroid hormones extend to the most advanced age and CENT/105+ are highly heterogeneous regarding thyroid function. This heterogeneity is related to different health, functional and cognitive status, as well as with survival/mortality in CENT/105+. Finally, we investigated a remarkable number of CENT/105+ showing a thyroid profile suggestive of non-thyroidal illness syndrome (NTIS) (excluded from the previous analysis). NTIS CENT/105+ are characterized by a worse functional and cognitive status and an increased mortality with respect to CENT/105+ without NTIS.

Happy older people live longer.
Chei CL, Lee JM, Ma S, Malhotra R.
Age Ageing. 2018 Aug 27. doi: 10.1093/ageing/afy128. [Epub ahead of print]
PMID: 30165421
Abstract
OBJECTIVE:
research on the role of positive affect, such as happiness, on health outcomes is burgeoning. Within this context, evidence for an inverse effect of happiness on mortality is inconclusive. Furthermore, few studies link happiness with mortality among older people, and in Asian populations. We examine the association between happiness and all-cause mortality among older people in Singapore.
METHODS:
data for 4,478 Singaporeans aged ≥60 years enrolled in a nationally-representative longitudinal survey (three waves: 2009; 2011; 2015) were utilised. Happiness, at baseline, in 2009, was measured using three positively-worded items from the Centre for Epidemiological Studies Depression Scale, and considered in two distinct ways in the analyses-continuous ('happiness score' [0-6]) and binary (happy [score = 6]/unhappy). All-cause mortality, until 31 December 2015, was assessed primarily using administrative databases, supplemented by data from survey waves 2 and 3. Multivariable Cox regression models assessed the association of 'happiness score' and the 'binary happiness variable' (separate models for each) with all-cause mortality.
RESULTS:
the likelihood of all-cause mortality was lower by 9% (multivariable hazard ratio (HR) [95% confidence interval]: 0.91 [0.87-0.95]) for each unit increase in 'happiness score', and was 19% lower for happy, versus unhappy, older people (HR: 0.81 [0.68-0.97]).
CONCLUSIONS:
happiness is associated with reduced likelihood of all-cause mortality among older people in an Asian population, with the benefit observed even for incremental increases in happiness. Activities, policies and programs that maintain or improve happiness may be beneficial for a longer life among older people.
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Does happiness itself directly affect mortality? The prospective UK Million Women Study.
Liu B, Floud S, Pirie K, Green J, Peto R, Beral V; Million Women Study Collaborators.
Lancet. 2016 Feb 27;387(10021):874-81. doi: 10.1016/S0140-6736(15)01087-9. Epub 2015 Dec 10.
PMID: 26684609 Free PMC Article
Abstract
BACKGROUND:
Poor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle factors that can affect mortality. We aimed to establish whether, after allowing for the poor health and lifestyle of people who are unhappy, any robust evidence remains that happiness or related subjective measures of wellbeing directly reduce mortality.
METHODS:
The Million Women Study is a prospective study of UK women recruited between 1996 and 2001 and followed electronically for cause-specific mortality. 3 years after recruitment, the baseline questionnaire for the present report asked women to self-rate their health, happiness, stress, feelings of control, and whether they felt relaxed. The main analyses were of mortality before Jan 1, 2012, from all causes, from ischaemic heart disease, and from cancer in women who did not have heart disease, stroke, chronic obstructive lung disease, or cancer at the time they answered this baseline questionnaire. We used Cox regression, adjusted for baseline self-rated health and lifestyle factors, to calculate mortality rate ratios (RRs) comparing mortality in women who reported being unhappy (ie, happy sometimes, rarely, or never) with those who reported being happy most of the time.
FINDINGS:
Of 719,671 women in the main analyses (median age 59 years [IQR 55-63]), 39% (282,619) reported being happy most of the time, 44% (315,874) usually happy, and 17% (121,178) unhappy. During 10 years (SD 2) follow-up, 4% (31,531) of participants died. Self-rated poor health at baseline was strongly associated with unhappiness. But after adjustment for self-rated health, treatment for hypertension, diabetes, asthma, arthritis, depression, or anxiety, and several sociodemographic and lifestyle factors (including smoking, deprivation, and body-mass index), unhappiness was not associated with mortality from all causes (adjusted RR for unhappy vs happy most of the time 0·98, 95% CI 0·94-1·01), from ischaemic heart disease (0·97, 0·87-1·10), or from cancer (0·98, 0·93-1·02). Findings were similarly null for related measures such as stress or lack of control.
INTERPRETATION:
In middle-aged women, poor health can cause unhappiness. After allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality.

Europace. 2008 May;10(5):618-23. doi: 10.1093/europace/eun071. Epub 2008 Apr 4.
Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study.
Molina L, Mont L, Marrugat J, Berruezo A, Brugada J, Bruguera J, Rebato C, Elosua R.
PMID: 18390875
Abstract
AIMS:
The aim of this study is to determine the incidence of lone atrial fibrillation (LAF) in males according to sport practice and to identify possible clinical markers related to LAF among marathon runners.
METHODS AND RESULTS:
A retrospective cohort study was designed. A group of marathon runners (n = 252) and a population-based sample of sedentary men (n = 305) recruited in 1990-92 and 1994-96, respectively, were contacted in 2002-03 and invited to attend an outpatient clinic to identify suggestive symptoms of having experienced an arrhythmia requiring medical attention. In those with suggestive symptoms of atrial fibrillation, medical records were reviewed. Finally, LAF was diagnosed on the basis of the presence of atrial fibrillation in an electrocardiographic recording. In the group of marathon runners, an echocardiogram was performed at inclusion and at the end of the study. The annual incidence rate of LAF among marathon runners and sedentary men was 0.43/100 and 0.11/100, respectively. Endurance sport practice was associated with a higher risk of incident LAF in the multivariate age- and blood pressure-adjusted Cox regression models (hazard ratio = 8.80; 95% confidence interval: 1.26-61.29). In the group of marathon runners, left atrial inferosuperior diameter and left atrial volume were both associated with a higher risk of incident LAF.
CONCLUSION:
Long-term endurance sport practice is associated with a higher risk of symptomatic LAF in men. This risk is associated with a larger left atrial inferosuperior diameter and volume in physically active subjects.

Resveratrol Supplementation Reduces Pain and Inflammation in Knee Osteoarthritis Patients Treated with Meloxicam: A Randomized Placebo-Controlled Study.
Marouf BH, Hussain SA, Ali ZS, Ahmmad RS.
J Med Food. 2018 Aug 30. doi: 10.1089/jmf.2017.4176. [Epub ahead of print]
PMID: 30160612
Abstract
Resveratrol, a polyphenolic compound, is a powerful antioxidant with remarkable anti-inflammatory properties. Inflammation and pain plays an important role in the pathogenesis of knee osteoarthritis (OA) and could cause tissue damage and morbidity. The aim of this study was to evaluate the anti-inflammatory and pain reduction activities of orally administered resveratrol in patients with knee OA. We carried out a 90-day pilot study to evaluate the ability of orally administered resveratrol, as an adjuvant with meloxicam, to decrease knee joint pain and biomarkers of inflammation in comparison with a placebo. One hundred ten men and women (45-75 years old) diagnosed with mild to moderate knee OA were treated with 15 mg per day meloxicam and either 500 mg per day resveratrol or placebo for 90 days in a double-blind, randomized control trial. Pain severity was evaluated at the beginning and at the end of treatment using Visual Analogue Scale-100 scores. Fasting blood was collected to determine serum interleukins 1β and 6, tumor necrosis factor-α, C-reactive protein, and complement proteins C3 and C4. The resveratrol-treated group experienced a time-dependent significant decrease in pain severity (P < .001). Serum levels of the biochemical markers were significantly reduced compared with the placebo-treated group (P < .01). These findings suggest that resveratrol may be an effective "add-on" option with meloxicam in the treatment of patients with mild to moderate knee OA.
KEYWORDS:
inflammatory markers; knee OA; knee pain; meloxicam; resveratrol

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Consuming glucose-sweetened, not fructose-sweetened, beverages increases fasting insulin in healthy humans.
Kuzma JN, Cromer G, Hagman DK, Breymeyer KL, Roth CL, Foster-Schubert KE, Holte SE, Weigle DS, Kratz M.
Eur J Clin Nutr. 2018 Aug 30. doi: 10.1038/s41430-018-0297-5. [Epub ahead of print]
PMID: 30166639
Abstract
Fructose-, compared to glucose-, sweetened beverages increase liver triglyceride content in the short-term, prior to weight gain. In secondary analyses of a randomized cross-over design study during which 24 healthy adults consumed 25% of their estimated energy requirement in the form of glucose-, fructose-, and high-fructose corn syrup-sweetened beverages in addition to an identical ad libitum diet for three periods of 8 days each, we investigated the hypothesis that fructose in sweetened beverages also triggers insulin resistance in the short term. Total energy intake, body weight, and fasting glucose did not differ among diet phases. However, there was a significant trend for higher fasting insulin (p = 0.042 for trend) and, among normal-weight participants, homeostasis model assessment index of insulin resistance (p = 0.034 for diet × adiposity interaction) according to the glucose content of the beverages. In conclusion, in contrast to our hypothesis, insulin resistance was increased with higher glucose vs. fructose content of the beverages in this short-term trial.

Beer, wine consumption, and 10-year CVD incidence: the ATTICA study.
Panagiotakos DB, Kouli GM, Magriplis E, Kyrou I, Georgousopoulou EN, Chrysohoou C, Tsigos C, Tousoulis D, Pitsavos C.
Eur J Clin Nutr. 2018 Aug 30. doi: 10.1038/s41430-018-0296-6. [Epub ahead of print]
PMID: 30166641
Abstract
BACKGROUND/OBJECTIVES:
Low/moderate alcohol consumption seems to be protective against cardiovascular disease (CVD). This study aimed to investigate the association of wine/beer consumption with the 10-year CVD incidence.
SUBJECTS/METHODS:
During 2001-2002, 3042 CVD-free adults consented to participate in the ATTICA study; of them 2583 completed the 10-year follow-up (85% participation rate), but precise information about fatal/nonfatal CVD incidence (myocardial infarction, angina pectoris, cardiac ischemia, heart failure, chronic arrhythmias, and stroke) was available in 2020 participants (overall retention rate 66%). Alcohol/ethanol intake and the alcoholic beverages consumed were assessed; participants were categorized into three groups (no use; ≤1 glass/week; >1 glass/week).
RESULTS:
Alcohol drinking was reported by 56% of the participants who did not develop a CVD event and 49% of those who had (p = 0.04); whereas ethanol intake was 14 ± 16 g among those who did not had an event vs. 21 ± 18 g among those who had a CVD event (p < 0.001). A strong inverse and similar association between low wine/beer intake (≤1 glass/week) and the risk of developing CVD was observed [HR: 0.40, 95% confidence interval (CI): 0.17-0.98; and HR: 0.43, 95% CI: 0.20-0.93, respectively], as compared to abstention. No significant association was found in participants exceeding drinking 1 glass/week compared with abstainers. Compared to <2 g/day ethanol intake, participants who reported 2-10, 10-20, and >20 g/day had CVD-risk HRs (95% CI) of 0.60 (0.40-0.98), 1.22 (0.60-1.14), and 1.81 (0.70-4.61), respectively.
CONCLUSIONS:
This study revealed similar results of low wine/beer consumption against CVD incidence, mainly due to its implication on low-grade chronic inflammation.

Acute effects of diets rich in almonds and walnuts on endothelial function.
Bhardwaj R, Dod H, Sandhu MS, Bedi R, Dod S, Konat G, Chopra HK, Sharma R, Jain AC, Nanda N.
Indian Heart J. 2018 Jul - Aug;70(4):497-501. doi: 10.1016/j.ihj.2018.01.030. Epub 2018 Feb 1.
PMID: 30170643
https://reader.elsevier.com/reader/sd/5112326E1CF92D693E949BF007765065C487955769800A7A49CDBB8508CD90A9EE2F9118E4B208366499B43A528C161C
Abstract
OBJECTIVE:
Omega-3 fatty acids, especially alpha-linolenic acid (ALA), which are present in nuts may reduce cardiovascular disease (CVD) risk, by changing vascular inflammation and improving endothelial dysfunction. The objective of the study was to evaluate the acute effects of two different diets, one containing walnuts and the other almonds on endothelial function.
METHODS:
Twenty-seven overweight volunteers underwent a randomized 2-period, crossover, controlled intervention study. The subjects were given either walnut or almond diets which varied in monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) content. The walnut diet provided 23.1% energy from PUFA and the almond diet provided 7.6% energy from PUFA. Endothelial function was assessed physiologically by flow-mediated dilation (FMD) and biochemically by sVCAM (soluble vascular cell adhesion molecules).
RESULTS:
The walnut diet significantly improved FMD (p=0.004) and decreased sVCAM (p=0.009) whereas the almond diet tended to improve FMD (p=0.06) and significantly decreased sVCAM (p=0.004).
CONCLUSION:
Both walnut and almond diets improved FMD and sVCAM and there was no significant difference in physiological and biochemical markers between the two diets.
KEYWORDS:
Almonds; Endothelial Function; Flow mediated dilation (FMD); MUFA; PUFA; Walnuts; sVCAM

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Fish intake and risk of mortality due to aortic dissection and aneurysm: A pooled analysis of the Japan cohort consortium.
Yamagishi K, Iso H, Shimazu T, Tamakoshi A, Sawada N, Matsuo K, Ito H, Wakai K, Nakayama T, Kitamura Y, Sado J, Tsuji I, Sugawara Y, Mizoue T, Inoue M, Nagata C, Sadakane A, Tanaka K, Tsugane S, Sasazuki S; Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan.
Clin Nutr. 2018 Aug 16. pii: S0261-5614(18)31349-9. doi: 10.1016/j.clnu.2018.08.007. [Epub ahead of print]
PMID: 30172657
https://sci-hub.tw/https://doi.org/10.1016/j.clnu.2018.08.007
Abstract
BACKGROUND & AIMS:
Many studies have suggested that fish intake is associated with protection from risk of atherosclerotic diseases; however, this association with aortic diseases has not been elucidated worldwide. We hypothesized that fish intake is inversely associated with mortality from aortic diseases (aortic dissection and aneurysm).
METHODS:
The study was conducted as a pooled analysis of original data from a maximum of 8 cohort studies, comprising a total of 366,048 community-based men and women who had no history of cardiovascular disease or cancer. In each cohort, we used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality from aortic dissection, aneurysm and total aortic disease according to the frequency of fish intake and estimated summary HRs derived from each study.
RESULTS:
Nonlinear inverse associations were found between fish intake and total aortic disease. Compared with persons who ate fish 1-2 times/week, persons who seldom ate fish had higher mortality from total aortic disease (multivariable-adjusted pooled HR = 1.93; 95% CI, 1.13-3.31). Higher mortality was not seen in those who ate fish 1-2 times/month. A similar pattern was observed for aortic dissection. Regarding aortic aneurysm, both persons who seldom ate fish and those who ate fish 1-2 times/month had higher mortality (HR = 1.99; 95% CI, 0.90-4.40 and HR = 1.86; 95% CI, 0.87-3.98, respectively).
CONCLUSIONS:
Persons who seldom ate fish had higher mortality from aortic dissection, aneurysm, and total aortic diseases.
KEYWORDS:
Diet; Epidemiology; Fatty acids; Meta-analysis; Prospective cohort study

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