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Pneumococcal polysaccharide vaccine associated with reduced lengths of stay for cardiovascular events hospital admissions: Experience from the Hunter Community Study.
Ren S, Holliday E, Hure A, Peel R, Hancock S, Leigh L, Oldmeadow C, Newby D, Li SC, Attia J.
Vaccine. 2018 Nov 26;36(49):7520-7524. doi: 10.1016/j.vaccine.2018.10.064. Epub 2018 Oct 24.
PMID: 30420042
Abstract
AIMS:
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP) and CAP-related mortality in adults. Pneumococcal vaccination (PV) could protect subjects from cardiovascular events by reducing pneumonia severity or even preventing it. We sought to determine the ability of PV to protect from the risk of cardiovascular events.
METHODS AND RESULTS:
A comprehensive search of electronic databases was conducted up to March 2014. Cohort studies that reported relative risk (RR) estimates with 95% confidence intervals (CI) were included. Eleven studies were included (332,267 participants, mean follow-up 20.1 months). The pooled RRs for cardiovascular events and cardiovascular mortality were 0.86 (95% CI: 0.76-0.97) and 0.92 (95% CI: 0.86-0.98; fixed-effects), respectively, for subjects with PV versus without PV. Protective ability was more prominent in high cardiovascular risk populations and with older age. The protective role of PV was attenuated after 1 year (RR: 0.72; 95% CI: 0.59-0.88 vs RR: 1.03; 95% CI: 0.93-1.14; p = 0.002, for follow-up >1 year vs ≤1 year, respectively). It also increased as the presence of cardiovascular and pulmonary disease increased. Regarding myocardial infarction (MI) and cerebrovascular events, the protective role of PV was statistically significant only in the elderly (RR: 0.90; 95% CI: 0.817-0.999; fixed-effects and RR: 0.86; 95% CI: 0.75-0.99, respectively).
CONCLUSION:
PV is associated with decreased risk of cardiovascular events and mortality. This protective effect increases at older age and in high cardiovascular risk subjects and decreases as the time elapses from PV. PV decreases the risk of MI and cerebrovascular events in the elderly.
KEYWORDS:
Pneumococcal vaccination; cardiovascular disease; cardiovascular mortality; meta-analysis; myocardial infarction; stroke
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Effect of the adult pneumococcal polysaccharide vaccine on cardiovascular disease: a systematic review and meta-analysis.
Ren S, Newby D, Li SC, Walkom E, Miller P, Hure A, Attia J.
Open Heart. 2015 Jun 26;2(1):e000247. doi: 10.1136/openhrt-2015-000247. eCollection 2015. Review.
PMID: 26196020 Free PMC Article
https://openheart.bmj.com/content/openhrt/2/1/e000247.full.pdf
Abstract
Animal models and clinical studies suggest a mechanistic link between the pneumococcal polysaccharide vaccine (PPV) and a cardiovascular protective effect. However, conflicting results exist from several large observational studies in humans. We set out to systematically review current literature and conduct meta-analyses of studies on PPV and cardiovascular outcomes. Medline, Embase and CENTRAL were searched for randomised controlled trials (RCTs) and observational studies in adults, using PPV as the intervention, up to 30 April 2014. Studies that compared PPV with a control (another vaccine, no vaccine or placebo) and recorded ischaemic events were included in this review. Two investigators extracted data independently on study design, baseline characteristics and summary outcomes. Study quality was examined using the Newcastle-Ottawa Quality Assessment Scale. Pooled estimates using random effects models and their 95% CIs were calculated separately for the outcomes of acute coronary syndrome (ACS) events and stroke. No RCT data were available. A total of 230 426 patients were included in eight observational studies and recorded as ACS events. PPV was associated with significantly lower odds of ACS events in patients 65 years and older (pooled OR=0.83 (95% CI 0.71 to 0.97), I(2)=77.0%). However, there was no significant difference in ACS events when younger people were included (pooled OR=0.86 (95% CI 0.73 to 1.01), I(2)=81.4%). Pooling of four studies, covering a total of 192 210 patients, did not find a significantly reduced risk of stroke in all patients (pooled OR=1.00 (95% CI 0.89 to 1.12), I(2)=55.3%), or when restricted to those 65 years and older (pooled OR=0.96 (95% CI 0.87 to 1.05), I(2)=22.5%). In this meta-analysis of observational studies, the use of PPV was associated with a significantly lower risk of ACS events in the older population, but not stroke. An adequately powered and blinded RCT to confirm these findings is warranted.
KEYWORDS:
MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)
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Association between pneumococcal vaccination and cardiovascular outcomes: a systematic review and meta-analysis of cohort studies.
Vlachopoulos CV, Terentes-Printzios DG, Aznaouridis KA, Pietri PG, Stefanadis CI.
Eur J Prev Cardiol. 2015 Sep;22(9):1185-99. doi: 10.1177/2047487314549512. Epub 2014 Sep 24. Review.
PMID: 25252595
Abstract
AIMS:
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP) and CAP-related mortality in adults. Pneumococcal vaccination (PV) could protect subjects from cardiovascular events by reducing pneumonia severity or even preventing it. We sought to determine the ability of PV to protect from the risk of cardiovascular events.
METHODS AND RESULTS:
A comprehensive search of electronic databases was conducted up to March 2014. Cohort studies that reported relative risk (RR) estimates with 95% confidence intervals (CI) were included. Eleven studies were included (332,267 participants, mean follow-up 20.1 months). The pooled RRs for cardiovascular events and cardiovascular mortality were 0.86 (95% CI: 0.76-0.97) and 0.92 (95% CI: 0.86-0.98; fixed-effects), respectively, for subjects with PV versus without PV. Protective ability was more prominent in high cardiovascular risk populations and with older age. The protective role of PV was attenuated after 1 year (RR: 0.72; 95% CI: 0.59-0.88 vs RR: 1.03; 95% CI: 0.93-1.14; p = 0.002, for follow-up >1 year vs ≤1 year, respectively). It also increased as the presence of cardiovascular and pulmonary disease increased. Regarding myocardial infarction (MI) and cerebrovascular events, the protective role of PV was statistically significant only in the elderly (RR: 0.90; 95% CI: 0.817-0.999; fixed-effects and RR: 0.86; 95% CI: 0.75-0.99, respectively).
CONCLUSION:
PV is associated with decreased risk of cardiovascular events and mortality. This protective effect increases at older age and in high cardiovascular risk subjects and decreases as the time elapses from PV. PV decreases the risk of MI and cerebrovascular events in the elderly.
KEYWORDS:
Pneumococcal vaccination; cardiovascular disease; cardiovascular mortality; meta-analysis; myocardial infarction; stroke

Sex-specific Effects of DHEA on Bone Mineral Density and Body Composition: A Pooled Analysis of Four Clinical Trials.
Jankowski CM, Wolfe P, Schmiege SJ, Nair KS, Khosla S, Jensen M, von Muhlen D, Laughlin GA, Kritz-Silverstein D, Bergstrom J, Bettencourt R, Weiss EP, Villareal DT, Kohrt WM.
Clin Endocrinol (Oxf). 2018 Nov 12. doi: 10.1111/cen.13901. [Epub ahead of print]
PMID: 30421439
https://sci-hub.tw/10.1111/cen.13901
Abstract
OBJECTIVE:
Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass, and fat-free mass in older women and men enrolled in four similar clinical trials.
DESIGN:
Pooled analyses of data from four double-blinded, randomized controlled trials.
PARTICIPANTS:
Women (n=295) and men (n=290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months.
MEASUREMENTS:
12-month changes in BMD, fat mass, fat-free mass, and serum DHEA sulfate (DHEAS), (17)estradiol, testosterone, and insulin-like growth factor-1 (IGF-1).
RESULTS:
Women on DHEA had increases (mean±SD; all p<0.001 vs placebo) in DHEAS (231±164 μg/dL), testosterone (18.6±20.9 μg/dL), (17)estradiol (8.7 ±11.0 pg/mL), and IGF-1 (25.1±52.3 ng/mL), and men had increases in DHEAS (269.0±177 μg/dL; p<0.01), (17)estradiol (4.8±12.2 pg/m; p<0.01), and IGF-1 (6.3±41.4 ng/mL; p<0.05). Women on DHEA had increases in lumbar spine (1.0%±3.4%) and trochanter (0.5%±3.8%) BMD and maintained total hip BMD (0.0%±2.8%); men had no BMD benefit and a decrease in fat mass (-0.4±2.6 kg; all p<0.01 vs placebo).
CONCLUSIONS:
DHEA therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are 1) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and 2) whether DHEA has a more favorable benefit-to-risk profile for women than estrogen therapy.
KEYWORDS:
aging; bone density; dehydroepiandrosterone; fat mass; fat-free mass; prohormone; sex differences

The effects of resveratrol intake on weight loss: a systematic review and meta-analysis of randomized controlled trials.
Tabrizi R, Tamtaji OR, Lankarani KB, Akbari M, Dadgostar E, Dabbaghmanesh MH, Kolahdooz F, Shamshirian A, Momen-Heravi M, Asemi Z.
Crit Rev Food Sci Nutr. 2018 Nov 13:1-16. doi: 10.1080/10408398.2018.1529654. [Epub ahead of print]
PMID: 30421960
Abstract
This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of resveratrol intake on weight loss. We searched the following databases until July 2018: MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Out of 831 reports, 36 RCTs were eligible for including to our meta-analysis. The pooled results, using random-effects model showed that resveratrol supplementation significantly decreased body weight (SMD = -0.17; 95% CI, -0.33, -0.01; P = 0.03; I2: 62.6), body mass index (BMI) (SMD = -0.20; 95% CI, -0.35, -0.05; P = 0.01; I2: 60.6), fat mass (SMD = -0.32; 95% CI, -0.62, -0.03; P = 0.03; I2: 77.9) and waist circumference (WC) (SMD = -0.42; 95% CI, -0.68, -0.16; P = 0.001; I2: 75.2), and significantly increased lean mass (SMD = 1.21; 95% CI, 0.75, 1.67; P < 0.001; I2: 87.6). We found no significant effect of resveratrol administration on leptin (SMD = -0.20; 95% CI, -0.68, 0.27; P = 0.40; I2: 85.3) and adiponectin levels (SMD = 0.08; 95% CI, -0.39, 0.55; P = 0.74; I2: 91.0). Resveratrol supplementation significantly decreased body weight in obese patients (SMD -0.43; 95% CI, -0.60, -0.26) compared with other diseases (SMD 0.02; 95% CI, -0.29, 0.33), and type 2 diabetes mellitus (SMD -0.17; 95% CI, -0.37, 0.02). Overall, the current meta-analysis demonstrated that resveratrol intake significantly reduced weight, BMI, WC and fat mass, and significantly increased lean mass, but did not affect leptin and adiponectin levels.
KEYWORDS:
Resveratrol; meta-analysis; overweight; weight loss

[I really think this study is unreliable in its findings because organic food consumers are such different people.]
Association of Frequency of Organic Food Consumption With Cancer Risk: Findings From the NutriNet-Santé Prospective Cohort Study.
Baudry J, Assmann KE, Touvier M, Allès B, Seconda L, Latino-Martel P, Ezzedine K, Galan P, Hercberg S, Lairon D, Kesse-Guyot E.
JAMA Intern Med. 2018 Oct 22. doi: 10.1001/jamainternmed.2018.4357. [Epub ahead of print]
PMID: 30422212
https://sci-hub.tw/10.1001/jamainternmed.2018.4357
Abstract
IMPORTANCE:
Although organic foods are less likely to contain pesticide residues than conventional foods, few studies have examined the association of organic food consumption with cancer risk.
OBJECTIVE:
To prospectively investigate the association between organic food consumption and the risk of cancer in a large cohort of French adults.
DESIGN, SETTING, AND PARTICIPANTS:
In this population-based prospective cohort study among French adult volunteers, data were included from participants with available information on organic food consumption frequency and dietary intake. For 16 products, participants reported their consumption frequency of labeled organic foods (never, occasionally, or most of the time). An organic food score was then computed (range, 0-32 points). The follow-up dates were May 10, 2009, to November 30, 2016.
MAIN OUTCOMES AND MEASURES:
This study estimated the risk of cancer in association with the organic food score (modeled as quartiles) using Cox proportional hazards regression models adjusted for potential cancer risk factors.
RESULTS:
Among 68 946 participants (78.0% female; mean [SD] age at baseline, 44.2 [14.5] years), 1340 first incident cancer cases were identified during follow-up, with the most prevalent being 459 breast cancers, 180 prostate cancers, 135 skin cancers, 99 colorectal cancers, 47 non-Hodgkin lymphomas, and 15 other lymphomas. High organic food scores were inversely associated with the overall risk of cancer (hazard ratio for quartile 4 vs quartile 1, 0.75; 95% CI, 0.63-0.88; P for trend = .001; absolute risk reduction, 0.6%; hazard ratio for a 5-point increase, 0.92; 95% CI, 0.88-0.96).
CONCLUSIONS AND RELEVANCE:
A higher frequency of organic food consumption was associated with a reduced risk of cancer. Although the study findings need to be confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.

A colorectal cancer diet quality index is inversely associated with colorectal cancer in the Malmö diet and cancer study.
Vulcan A, Ericson U, Manjer J, Ohlsson B.
Eur J Cancer Prev. 2018 Nov 12. doi: 10.1097/CEJ.0000000000000486. [Epub ahead of print]
PMID: 30422929
Abstract
The World Cancer Research Fund International has concluded strong evidence for that high intake of dairy products and foods containing dietary fiber and low intake of processed meat are associated with decreased risk of colorectal cancer (CRC). As food items are consumed together, it is important to study dietary patterns. The aim of the present study was to examine the association between an a priori constructed dietary index and incident CRC and between intake of processed meat, fiber, and dairy products and CRC. In the Malmö Diet and Cancer study cohort, 923 cases of CRC were identified, during 502 136 person-years of follow-up. A Colorectal Diet Quality Index (CDQI) was constructed regarding intakes of processed meat, fiber, and dairy products in relation to CRC. Higher index indicated a higher dietary quality. Higher CDQI was associated with lower risk of CRC [hazard ratios (HR): 0.57 for highest compared with lowest quintile; 95% confidence interval (CI): 0.43, 0.75; P<0.001]. Intake of dairy products was inversely associated with risk of CRC [HR for highest vs. lowest quintile was 0.77 (CI: 0.62, 0.96); P=0.008], as was dietary fiber (HR for highest vs. lowest quintile was 0.77 (CI: 0.61, 0.98); P=0.043). High intake of processed meat was associated with CRC (HR for highest vs. lowest quintile was 1.31; CI: 1.05, 1.63; P=0.012). High adherence to a predefined CRC-specific diet quality index was inversely associated with the risk of CRC and gave a stronger association with CRC, than when analyzing the components of the CDQI individually.

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Short-Term Effects of Healthy Eating Pattern Cycling on Cardiovascular Disease Risk Factors: Pooled Results from Two Randomized Controlled Trials.
O'Connor L, Li J, Sayer RD, Hennessy JE, Campbell W.
Nutrients. 2018 Nov 10;10(11). pii: E1725. doi: 10.3390/nu10111725.
PMID: 30423846
https://www.mdpi.com/2072-6643/10/11/1725
Abstract
Adherence to healthy eating patterns (HEPs) is often short-lived and can lead to repetitive attempts of adopting-but not maintaining-HEPs. We assessed effects of adopting, abandoning, and readopting HEPs (HEP cycling) on cardiovascular disease risk factors (CVD-RF). We hypothesized that HEP cycling would improve, worsen, and again improve CVD-RF. Data were retrospectively pooled for secondary analyses from two randomized, crossover, controlled feeding trials (n = 60, 52 ± 2 years, 30.6 ± 0.6 kg/m²) which included two 5⁻6 week HEP interventions (Dietary Approaches to Stop Hypertension-style or Mediterranean-style) separated by a four-week unrestricted eating period. Ambulatory and fasting blood pressures (BP), fasting serum lipids, lipoproteins, glucose, and insulin were measured before and during the last week of HEP interventions. Fasting systolic BP and total cholesterol decreased (-6 ± 1 mm Hg and -19 ± 3 mg/dL, respectively, p < 0.05), returned to baseline, then decreased again (-5 ± 1 mm Hg and -13 ± 3 mg/dL, respectively, p < 0.05) when adopting, abandoning, and readopting a HEP; magnitude of changes did not differ. Ambulatory and fasting diastolic BP and high-density lipoprotein cholesterol concentrations followed similar patterns; glucose and insulin remained unchanged. Low-density lipoprotein cholesterol concentrations decreased with initial adoption but not readoption (-13 ± 3 and -6 ± 3, respectively, interaction p = 0.020). Healthcare professionals should encourage individuals to consistently consume a HEP for cardiovascular health but also encourage them to try again if a first attempt is unsuccessful or short-lived.
KEYWORDS:
Dietary Approaches to Stop Hypertension eating patter; Mediterranean-style eating pattern; dietary cycling; dietary guidance; healthy eating pattern; overweight and obese adults

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Intake of vitamin B6, folate, and vitamin B12 and risk of coronary heart disease: a systematic review and dose-response meta-analysis of prospective cohort studies.
Jayedi A, Zargar MS.
Crit Rev Food Sci Nutr. 2018 Nov 15:1-11. doi: 10.1080/10408398.2018.1511967. [Epub ahead of print]
PMID: 30431328
Abstract
The objective of this study was to quantify the association of B-vitamins intake with the future risk of coronary heart disease (CHD). A systematic search was performed with the use of PubMed and Scopus from inception to April 30, 2018. Prospective cohort studies evaluating the association of intake of folate, vitamin B6, and vitamin B12 with risk of CHD in the general population were included. A random-effects meta-analysis was performed. Eleven prospective cohort studies (total n = 369,746) with 5133 cases of CHD were included in the analyses. The relative risks were: 0.79 (95%CI: 0.69, 0.89; I2 = 67%) for a 250 µg/d increment in folate intake; 0.87 (95%CI: 0.78, 0.96; I2 = 80%) for a 0.5 mg/d increment in vitamin B6 intake; and 0.97 (95%CI: 0.80, 1.14: I2 = 67%) for a 3 µg/d increment in vitamin B12 intake. The results did not change materially when the analyses were restricted only to dietary vitamins intake. A nonlinear dose-response meta-analysis demonstrated a linear inverse association between folate and vitamin B6 intake and risk of CHD. In conclusion, higher intake of folate and vitamin B6 is associated with a lower risk of CHD in the general population.
KEYWORDS:
Coronary heart disease; folic acid; meta-analysis; vitamin B6

Probiotic Yogurt for the Prevention of Antibiotic-associated Diarrhea in Adults: A Randomized Double-blind Placebo-controlled Trial.
Velasco M, Requena T, Delgado-Iribarren A, Peláez C, Guijarro C.
J Clin Gastroenterol. 2018 Nov 14. doi: 10.1097/MCG.0000000000001131. [Epub ahead of print]
PMID: 30439760
Abstract
GOAL:
To evaluate the effect of yogurt supplemented with probiotic bacteria on the prevention of antibiotic-associated diarrhea (AAD) in hospitalized patients.
BACKGROUND:
Diarrhea following antibiotic administration is a frequent clinical problem. The usefulness of probiotics for the prevention of AAD in the hospitalized adult population remains unclear.
STUDY:
A randomized, double-blind, placebo-controlled clinical trial was conducted in hospitalized patients who started antibiotic treatment. Patients were randomized (2:2:1) to receive a daily amount of 200 mL of placebo-yogurt (Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus), 200 mL of probiotic yogurt (previous plus Lactobacillus acidophilus La-5, Bifidobacterium animalis subsp. lactis Bb-12 and Lactobacillus casei subsp. casei Lc-01 or no yogurt (unblinded control) within 48 hours of beginning the antibiotic therapy and up to 5 days after stopping the antibiotic. Patients were followed up with for 1 month to determine occurrence of diarrhea.
RESULTS:
We included 314 patients, mean age 76 years. The rate of diarrhea was 23.0% in the probiotic group versus 17.6% in the placebo group, absolute risk reduction -5.35% (95% confidence interval, -15.4% to 4.7%; P=0.30). Rate of diarrhea was similar in the unblinded external control and in the blinded study groups combined (20.9% vs. 20.2% respectively; P=0.91). There was no difference in the duration of diarrhea, maximum number of bowel movements or prolonged admission because of diarrhea among the groups. All-cause mortality did not differ between groups.
CONCLUSIONS:
The combined probiotic strains LA-5, BB-12, and LC-01 do not have an effect in the prevention of AAD in hospitalized patients.

The beneficial effects of Lactobacillus reuteri ADR-1 or ADR-3 consumption on type 2 diabetes mellitus: a randomized, double-blinded, placebo-controlled trial.
Hsieh MC, Tsai WH, Jheng YP, Su SL, Wang SY, Lin CC, Chen YH, Chang WW.
Sci Rep. 2018 Nov 14;8(1):16791. doi: 10.1038/s41598-018-35014-1.
PMID: 30429496
https://www.nature.com/articles/s41598-018-35014-1
https://www.nature.com/articles/s41598-018-35014-1.pdf
Abstract
Probiotics have been reported to ameliorate symptoms of type 2 diabetes mellitus (T2DM) in animal models and human studies. We previously demonstrated that oral administration of Lactobacillus reuteri ADR-3 reduced insulin resistance in high-fructose-fed (HFD) rats. In the present study, we first identified another L. reuteri strain, ADR-1, which displayed anti-diabetes activity that reduced the levels of serum HbA1c and cholesterol and that increased antioxidant proteins in HFD rats. We further performed a randomized, double-blinded, placebo-controlled trial with a total of 68 T2DM patients to examine the beneficial effects of oral consumption of L. reuteri strains ADR-1 and ADR-3 and to investigate the associated changes in intestinal flora using a quantitative PCR method to analyze 16 S rRNA in fecal specimens. Significant reductions in HbA1c and serum cholesterol were observed in participants in the live ADR-1 consumption group (n = 22) after 3 months of intake when compared with those in the placebo group (n = 22). Although there was no significant difference in the HbA1c serum level among participants who consumed heat-killed ADR-3 (n = 24), the systolic blood pressure and mean blood pressure were significantly decreased after 6 months of intake. There was no obvious change in serum inflammatory cytokines or antioxidant proteins in participants after intaking ADR-1 or ADR-3, except for a reduction in IL-1β in the ADR-3 consumption group after 6 months of intake. With the analysis of fecal microflora, we found that L. reuteri or Bifidobacterium spp. were significantly increased in the ADR-1 and ADR-3 consumption groups, respectively, after 6 months of intake. Interestingly, a significant reduction in HbA1c was observed in the ADR-1 and ADR-3 consumption participants who displayed at least an 8-fold increase in fecal L. reuteri. We also observed that there was a significantly positive correlation between Bifidobacterium spp. and Lactobacillus spp. in participants with increased levels of fecal L. reuteri. In the ADR-1 intake group, the fecal Lactobacillus spp. level displayed a positive correlation with Bifidobacterium spp. but was negatively correlated with Bacteroidetes. The total level of fecal L. reuteri in participants in the ADR-3 consumption group was positively correlated with Firmicutes. In conclusion, L. reuteri strains ADR-1 and ADR-3 have beneficial effects on T2DM patients, and the consumption of different strains of L. reuteri may influence changes in intestinal flora, which may lead to different outcomes after probiotic intake.

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Vitamin D3 prevents cardiovascular diseases by lowering serum total homocysteine concentrations in overweight reproductive women: A randomized, placebo-controlled clinical trial.
Al-Bayyari N, Al-Zeidaneen S, Hailat R, Hamadneh J.
Nutr Res. 2018 Nov;59:65-71. doi: 10.1016/j.nutres.2018.07.012. Epub 2018 Jul 29.
PMID: 30442234
https://sci-hub.tw/10.1016/j.nutres.2018.07.012
Abstract
Obesity and overweight are associated with vitamin D deficiency and hyperhomocysteinemia, all of which are contributing factors for developing cardiovascular disease (CVD). Therefore, we hypothesized that improving serum 25-hydroxyvitamin D [25(OH)D] levels may decrease the body weight and total homocysteine concentrations among overweight reproductive women. To test our hypothesis, a randomized, double-blind placebo-controlled clinical trial, registered under ClinicalTrials.gov Identifier No. NCT03310307, was conducted on 100 overweight reproductive women that were allocated into two groups, namely, the treatment group (n = 50), which received 50 000 IU vitamin D3 per week, and the placebo group (n = 50), and followed for 2 months. Participants' 25(OH)D, homocysteine, parathyroid hormone, calcium, phosphorus, body weight and body mass index (BMI) were measured and compared before and after treatment. The results showed that there was a significant decrease in homocysteine levels after the first and second months of vitamin D3 intervention in the treatment group, and no significant changes were seen in the placebo group throughout the period of follow up. Statistically significant (P ≤ .05) reductions in homocysteine concentration, body weight, BMI, and parathyroid hormone levels were noticed in the treatment group compared to the placebo. Meanwhile, 25(OH)D, calcium and phosphorus levels were statistically significantly (P ≤ .05) increased in the treatment group. In conclusion, vitamin D3 intervention with a treatment dose of 50 000 IU per week for at least 2 months can help decrease BMI and homocysteine levels, which in turn will help prevent or minimize the risk of CVD among overweight women of reproductive age.
KEYWORDS:
Homocysteine; Overweight; Reproductive women; Vitamin D(3)

Title: Dietary Sodium Intake is Associated with Long-Term Risk of New-Onset Atrial Fibrillation.
Pääkkö TJW, Perkiömäki JS, Silaste ML, Bloigu R, Huikuri HV, Kesäniemi YA, Ukkola OH.
Ann Med. 2018 Nov 15:1-27. doi: 10.1080/07853890.2018.1546054. [Epub ahead of print]
PMID: 30442022
Abstract
BACKGROUND:
The association between dietary salt intake and hypertension has been well documented. We evaluated the association between dietary sodium intake and the incidence of new-onset atrial fibrillation (AF) during a mean follow-up of 19 years among 716 subjects from the OPERA cohort.
MATERIAL AND METHODS:
Dietary sodium intake was evaluated from a 7-day food record. The diagnosis of AF (atrial flutter included) was made if ICD-10 code I48 was listed in the hospital discharge records during follow-up.
RESULTS:
In the Kaplan-Meier curves, when quartiles of sodium consumption were considered, the cumulative proportional probabilities for AF events were higher in the highest (4th) quartile (16.8%) than in the lower quartiles (1st 6.7%, 2nd 7.3%, and 3rd 10.6%) (p = 0.003). In the Cox regression analysis, sodium consumption (g/1,000kcal) as a continuous variable was independently associated with AF events ((Hazard Ratio =2.1 (95% CI, 1.2 to 3.7) p = 0.015) when age, body mass index, smoking (pack-years), office systolic blood pressure, left atrium diameter, left ventricular mass index and the use of any antihypertensive therapy were added as covariates.
CONCLUSIONS:
These findings indicate that sodium intake is associated with the long-term risk of new-onset AF. Further confirmatory studies are needed.
KEYWORDS:
atrial fibrillation; sodium consumption; sodium intake

Active Commuting and Multiple Health Outcomes: A Systematic Review and Meta-Analysis.
Dinu M, Pagliai G, Macchi C, Sofi F.
Sports Med. 2018 Nov 16. doi: 10.1007/s40279-018-1023-0. [Epub ahead of print] Review.
PMID: 30446905
https://sci-hub.tw/10.1007/s40279-018-1023-0
Abstract
BACKGROUND:
Active commuting is associated with greater physical activity, but there is no consensus on the actual beneficial effects of this type of physical activity on health outcomes.
OBJECTIVE:
To examine the association between active commuting and risk of all-cause mortality, incidence and mortality from cardiovascular diseases, cancer and diabetes through meta-analysis.
METHODS:
A comprehensive search of MEDLINE, Embase, Google Scholar, Web of Science, The Cochrane Library, Transport Research International Documentation database, and reference lists of included articles was conducted. Only prospective cohort studies were included.
RESULTS:
Twenty-three prospective studies including 531,333 participants were included. Participants who engaged in active commuting had a significantly lower risk of all-cause mortality [relative risk (RR) 0.92, 95% CI 0.85-0.98] and cardiovascular disease incidence (RR 0.91; 95% CI 0.83-0.99). There was no association between active commuting and cardiovascular disease mortality and cancer. Participants who engaged in active commuting had a 30% reduced risk of diabetes (RR 0.70; 95% CI 0.61-0.80) in three studies after removal of an outlying study that affected the heterogeneity of the results. Subgroup analyses suggested a significant risk reduction (- 24%) of all-cause mortality (RR 0.76; 95% CI 0.63-0.94) and cancer mortality (- 25%; RR 0.75; 95% CI 0.59-0.895) among cycling commuters.
CONCLUSION:
People who engaged in active commuting had a significantly reduced risk of all-cause mortality, cardiovascular disease incidence and diabetes.

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Carbohydrate nutrition variables and risk of disability in instrumental activities of daily living.
Gopinath B, Flood VM, Burlutksy G, Liew G, Mitchell P.
Eur J Nutr. 2018 Nov 17. doi: 10.1007/s00394-018-1865-0. [Epub ahead of print]
PMID: 30448879
https://sci-hub.tw/https://link.springer.com/article/10.1007/s00394-018-1865-0
Abstract
PURPOSE:
We aimed to examine the prospective association between dietary glycemic index (GI) and glycemic load (GL) of foods consumed, intakes of carbohydrates and fiber, and the ability to perform activities of daily living (ADL) in older adults.
METHODS:
A total of 844 participants from the Blue Mountains Eye Study aged 60 years or older were examined from 2002-2004 to 2007-2009. Dietary information was collected using a validated, semi-quantitative food-frequency questionnaire. The Older Americans Resources and Services activities of daily living scale were administered to assess the functional status of participants. Multivariable logistic regression analysis was performed.
RESULTS:
After multivariable adjustment, participants who were in the second and third quartiles of energy-adjusted total fiber intake compared to those in the first quartile of intake (reference group) at baseline had reduced risk of incident impaired instrumental activities of daily living (IADL) 5 years later: OR, 0.39 (95% CI 0.22-0.70) and OR 0.54 (95% CI 0.30-0.95), respectively. Analyses that involved dichotomized total fiber intake showed that participants in the upper three quartiles of total fiber intake (> 19 g/day), compared to those in the lowest quartile of intake (≤ 19 g/day) or reference group, had reduced IADL disability risk 5 years later: OR 0.49 (95% CI 0.31-0.79). Non-significant associations were observed with total carbohydrates, GI, and GL and with risk of impaired total and basic ADL at 5-year follow-up.
CONCLUSIONS:
Habitual fiber consumption might be beneficial in leading to improved health status subserving performance of instrumental daily activities, needed to function in the community.
KEYWORDS:
Activities of daily living; Blue mountains eye study; Carbohydrate nutrition; Fiber; Incidence; Older adults

The potential nutrigeroprotective role of Mediterranean diet and its functional components on telomere length dynamics.
Davinelli S, Trichopoulou A, Corbi G, De Vivo I, Scapagnini G.
Ageing Res Rev. 2018 Nov 15. pii: S1568-1637(18)30198-3. doi: 10.1016/j.arr.2018.11.001. [Epub ahead of print] Review.
PMID: 30448616
https://sci-hub.tw/https://linkinghub.elsevier.com/retrieve/pii/S1568163718301983
Abstract
The Mediterranean diet (MD) is a gold standard for nutrition and the most evidence-based diet to delay the onset of age-associated pathologies. Telomeres are the heterochromatic repeat regions found at the ends of eukaryotic chromosomes, whose length is considered a reliable hallmark of biological ageing. Telomere shortening is, at least in part, a modifiable factor and there is evidence that adherence to the MD is associated with longer telomeres. Data from several studies indicate an association between "inflammatory/oxidative status" and telomere length (TL). The MD, as a complex exposome with thousands of nutrients and phytochemicals, may positively influence telomere attrition by reducing inflammation and oxidative stress. However, it is unclear whether the protective effects on TL provided by the MD result from its individual constituents or some combination of these. Furthermore, these properties of the MD and its components are not yet fully validated by clinical endpoints in randomized trials or observational studies. Here, we summarize the data from experimental and population-based studies on the effects of the MD on TL maintenance. We will both highlight the possible role of the MD in the prevention of age-associated diseases, and attempt to identify certain aspects of the diet that are particularly important for telomere maintenance.
KEYWORDS:
Mediterranean diet; ageing; food; phytochemicals; telomere

https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-14-25
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Frailty phenotype, frailty index and risk of mortality in Chinese elderly population- Rugao longevity and ageing study.
Shi GP, Ma T, Zhu YS, Wang ZD, Chu XF, Wang Y, Chen ZK, Xu WD, Wang XF, Guo JH, Jiang XY.
Arch Gerontol Geriatr. 2018 Nov 6;80:115-119. doi: 10.1016/j.archger.2018.11.001. [Epub ahead of print]
PMID: 30448694
Abstract
BACKGROUND:
To explore the associations of frailty phenotype and frailty index (FI) defined frailty and pre-frailty with mortality in a Chinese elderly population.
METHODS:
Data of 1788 community-dwelling elders aged 70-84 years from the ageing arm of Rugao Longevity and Ageing Study, a prospective cohort study, were used. Frailty phenotype was defined using modified Fried's phenotype (FP) criteria and FI was constructed using 45 health deficits. Mortality was ascertained using the Death Registry of Rugao's Civil Affairs Bureau.
RESULTS:
During 3-year follow-up, 149 (8.3%) of the 1788 elderly subjects died. For frailty phenotype, about 9.5% of the elderly were frail and 43% were pre-frail. For FI, frail (FI > 0.21) was approximately 27.5%, and pre-frail (FI: 0.1-0.21) was approximately 51.3%. Highest mortality was observed among frail participants defined by both FP and FI criteria (all Log Rank P < 0.05). Frailty defined by the frailty index was associated with a 2.31 fold (95% CI 1.16-4.6) risk of all-cause death compared with robust elderly. Compared with the robust elderly, not only frailty (HR 2.24, 95% CI 1.31-3.83) defined by frailty phenotype but also pre-frailty (HR 1.51, 95% CI 1.03-2.21) was associated with risk of all-cause mortality.
CONCLUSIONS:
Frailty, defined by either phenotype or index, is associated with increased risks of mortality in elderly Chinese community population.
KEYWORDS:
Frailty index; Frailty phenotype; Pre-frailty; Prospective cohort study

Dietary fat: From foe to friend?
Ludwig DS, Willett WC, Volek JS, Neuhouser ML.
Science. 2018 Nov 16;362(6416):764-770. doi: 10.1126/science.aau2096. Review.
PMID: 30442800
http://science.sciencemag.org/content/362/6416/764
Abstract
For decades, dietary advice was based on the premise that high intakes of fat cause obesity, diabetes, heart disease, and possibly cancer. Recently, evidence for the adverse metabolic effects of processed carbohydrate has led to a resurgence in interest in lower-carbohydrate and ketogenic diets with high fat content. However, some argue that the relative quantity of dietary fat and carbohydrate has little relevance to health and that focus should instead be placed on which particular fat or carbohydrate sources are consumed. This review, by nutrition scientists with widely varying perspectives, summarizes existing evidence to identify areas of broad consensus amid ongoing controversy regarding macronutrients and chronic disease.

The gut microbiota at the intersection of diet and human health.
Gentile CL, Weir TL.
Science. 2018 Nov 16;362(6416):776-780. doi: 10.1126/science.aau5812. Review.
PMID: 30442802
http://science.sciencemag.org/content/362/6416/776
Abstract
Diet affects multiple facets of human health and is inextricably linked to chronic metabolic conditions such as obesity, type 2 diabetes, and cardiovascular disease. Dietary nutrients are essential not only for human health but also for the health and survival of the trillions of microbes that reside within the human intestines. Diet is a key component of the relationship between humans and their microbial residents; gut microbes use ingested nutrients for fundamental biological processes, and the metabolic outputs of those processes may have important impacts on human physiology. Studies in humans and animal models are beginning to unravel the underpinnings of this relationship, and increasing evidence suggests that it may underlie some of the broader effects of diet on human health and disease.

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White Coat, Black Art
DR. GOLDMAN'S BLOG
How loud noises can affect your heart
https://www.cbc.ca/radio/whitecoat/how-loud-noises-can-affect-your-heart-1.4911172
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Chronic exposure to excess noise may increase risk for heart disease, stroke
Michael T. Osborne, M.D.; Brian Tung, M.S.; Tomas Patrich, B.A.; Blake Oberfeld, B.S.; Ying Wang, M.D.; Roger Pitman, M.D.; and Ahmed Tawakol
American Heart Association Meeting Report – Poster Presentation Su1287, Session: PR.APS.02
November 05, 2018
https://newsroom.heart.org/news/chronic-exposure-to-excess-noise-may-increase-risk-for-heart-disease-stroke

Mortality risk of loneliness in the oldest old over a 10-year follow-up.
Wang H, Leng Y, Zhao E, Fleming J, Brayne C; CC75C Study Collaboration.
Aging Ment Health. 2018 Nov 17:1-6. doi: 10.1080/13607863.2018.1510897. [Epub ahead of print]
PMID: 30450926
Abstract
OBJECTIVE:
To investigate the impact of loneliness on all-cause mortality in the oldest old population over a 10-year follow-up.
METHOD:
Participants were from the third wave of the Cambridge City over-75s Cohort (CC75C) study, a population-based longitudinal study of older people aged 75 or over. Loneliness was measured two further times. At each wave, participants were asked how often they felt lonely and the answers were divided into three levels: not lonely, slightly lonely and lonely. The relationship between loneliness and all-cause mortality was examined using Cox regression with loneliness as a time-varying predictor. The association was adjusted for socio-demographic factors, number of chronic diseases, functional ability and depression.
RESULTS:
Seven hundred thirteen participants were seen at wave 3 (out of 2166 at baseline), of whom 665 had data on loneliness. The prevalence of feeling slightly lonely and lonely was 16% and 25%, respectively. Vital status was followed for a further 10 years. A total of 562 participants died during the follow-up. After adjusting for age, sex and other socio-demographic factors, loneliness was associated with a 20% increased risk of mortality (HR: 1.2, 95% CI: 1.0-1.6). The association was disappeared after further adjusting for health conditions and depression (HR: 1.0, 95% CI: 0.8-1.4). Individuals who reported being slightly lonely were not at risk of mortality.
CONCLUSIONS:
The association between loneliness and mortality was fully explained by health conditions, suggesting that in the very old age, health problem is the proximal risk factor for mortality.
KEYWORDS:
Loneliness; longitudinal analysis; mortality; the oldest old

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Coffee, Green Tea, and Caffeine Intake and Liver Cancer Risk: A Prospective Cohort Study.
Tamura T, Wada K, Konishi K, Goto Y, Mizuta F, Koda S, Hori A, Tanabashi S, Matsushita S, Tokimitsu N, Nagata C.
Nutr Cancer. 2018 Nov 20:1-7. doi: 10.1080/01635581.2018.1512638. [Epub ahead of print]
PMID: 30457014
Abstract
We aimed to investigate whether coffee, green tea, and caffeine intake are associated with liver cancer risk, using data of a prospective cohort study. This study included 30,824 participants (14,240 men and 16,584 women) aged 35 years or older in the Takayama study, which was launched on September 1, 1992. The consumption frequencies of coffee and green tea were assessed using a self-administered questionnaire. Caffeine intake was estimated from the consumption frequencies of caffeine-containing beverages and foods and their caffeine content per serving. The incidence of liver cancer was confirmed using regional population-based cancer registries. During the follow-up period of 16 years, a total of 172 participants developed liver cancer. The adjusted hazard ratios and 95% confidence intervals (CIs) in relation to coffee consumption were 0.65 (95% CI: 0.46-0.93) for less than once per day, 0.63 (95% CI: 0.39-1.02) for once per day, and 0.40 (95% CI: 0.20-0.79) for twice per day or more, compared with nondrinkers. No associations with green tea, black tea and caffeine intake were observed. The present study confirmed that coffee consumption significantly reduces liver cancer risk and raises the possibility that caffeine intake might not account for the association.

Is the Response of Tumours Dependent on the Dietary Input of Some Amino Acids or Ratios among Essential and Non-Essential Amino Acids? All That Glitters Is Not Gold.
Dioguardi FS, Flati V, Corsetti G, Pasini E, Romano C.
Int J Mol Sci. 2018 Nov 17;19(11). pii: E3631. doi: 10.3390/ijms19113631. Review.
PMID: 30453654
[pdf is free from https://www.preprints.org/manuscript/201810.0428/v1 .]
Abstract
Energy production is the main task of the cancer cell metabolism because the costs of duplicating are enormous. Although energy is derived in cells by dismantling the carbon-to-carbon bonds of any macronutrient, cancer nutritional needs for energetic purposes have been studied primarily as being dependent on glycolysis. Since the end of the last century, the awareness of the dependence of cancer metabolism on amino acids not only for protein synthesis but also to match energy needs has grown. The roles of specific amino acids such as glutamine, glycine and serine have been explored in different experimental conditions and reviewed. Moreover, epidemiological evidence has revealed that some amino acids used as a supplement for therapeutic reasons, particularly the branched-chain ones, may reduce the incidence of liver cancer and a specific molecular mechanism has been proposed as functional to their protective action. By contrast and puzzling clinicians, the metabolomic signature of some pathologies connected to an increased risk of cancer, such as prolonged hyperinsulinemia in insulin-resistant patients, is identified by elevated plasma levels of the same branched-chain amino acids. Most recently, certain formulations of amino acids, deeply different from the amino acid compositions normally present in foods, have shown the power to master cancer cells epigenetically, slowing growth or driving cancer cells to apoptotic death, while being both beneficial for normal cell function and the animal's health and lifespan. In this review, we will analyze and try to disentangle some of the many knots dealing with the complexities of amino acid biology and links to cancer metabolism.
KEYWORDS:
amino acids; apoptosis; autophagy; cancer; diabetes type 2; energy metabolism; glutamine

Occupational variation in the risk of female breast cancer in the Nordic countries.
Katuwal S, Martinsen JI, Kjaerheim K, Sparen P, Tryggvadottir L, Lynge E, Weiderpass E, Pukkala E.
Cancer Causes Control. 2018 Nov;29(11):1027-1038. doi: 10.1007/s10552-018-1076-2. Epub 2018 Aug 27.
PMID: 30151565
https://sci-hub.tw/10.1007/s10552-018-1076-2
Abstract
OBJECTIVE:
This study aimed to determine occupational variations in the incidence of breast cancer in the population-based cohort of Nordic Occupational Cancer Study (NOCCA).
METHODS:
The study included long-term follow-up data from almost 7.5 million Nordic women. Participants were assigned to one of the 54 occupational categories based on census records at the ages of 30-64 years. Sixty-two thousand cases of breast cancer were identified through record linkages between nationwide cancer registries in Finland, Sweden, Norway, Denmark, and Iceland, followed up between 1961 and 2005. Country-specific standardized incidence ratios (SIRs) with 95% confidence intervals were estimated.
RESULTS:
Overall, the highest risk elevations were seen among military personnel (SIR 1.58, 95% CI 1.03-2.32), dentists (SIR 1.43, 95% CI 1.31-1.56), and physicians (SIR 1.35, 95% CI 1.26-1.46). The lowest risks were observed among gardeners (SIR 0.76, 95% CI 0.74-0.78), farmers (SIR 0.80, 95% CI 0.78-0.82), and woodworkers (SIR 0.75, 95% CI 0.70-0.81). Welders, tobacco workers, and painters had higher SIRs for breast cancer diagnosed at age < 50. A reduced risk was observed among forestry workers, welders, and fishery workers for breast cancers diagnosed both before and after age 50. The SIRs for breast cancer did not vary substantially by histology. A significantly increased risk of breast cancer was observed among laboratory workers in the latest calendar period (1991-2005) compared with earlier periods (1976-1990 and 1961-1975). Occupations such as farming, forestry, driving, and gardening had low SIRs during all periods.
CONCLUSIONS:
The study suggests that the risk of breast cancer varies by occupation. Heterogeneity is also observed in some occupational categories according to age (before or after 50), histology, and calendar period.
KEYWORDS:
Breast cancer; Nordic; Occupational exposure; Risk factors

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Associations between Phytoestrogens, Glucose Homeostasis, and Risk of Diabetes in Women: A Systematic Review and Meta-Analysis.
Glisic M, Kastrati N, Gonzalez-Jaramillo V, Bramer WM, Ahmadizar F, Chowdhury R, Danser AJ, Roks AJ, Voortman T, Franco OH, Muka T.
Adv Nutr. 2018 Nov 1;9(6):726-740. doi: 10.1093/advances/nmy048.
PMID: 30462180
Abstract
Phytoestrogens might have advantageous effects on diabetes in women. We performed a systematic review and meta-analysis to determine the effect of phytoestrogens on glucose homeostasis and the risk of type 2 diabetes (T2D) among women. Randomized controlled trials (RCTs) and prospective observational studies that assessed associations of phytoestrogens (supplementation, dietary intake, or biomarkers) with fasting glucose or insulin, homeostatic model assessment of insulin resistance (HOMA-IR), or with the risk of T2D were included. We identified 18 RCTs (n = 1687 individuals) investigating the effect of phytoestrogen supplementation on glucose homeostasis and 9 prospective population-based studies (n = 212,796 individuals) examining the association between phytoestrogen intake and the risk of T2D. Compared with placebo, phytoestrogen supplementation resulted in improvements in fasting glucose and HOMA-IR: the pooled mean differences of changes were -0.12 mmol/L (95% CI: -0.20, -0.03 mmol/L) and -0.24 mmol/L (95% CI: -0.45, -0.03 mmol/L), respectively. Although there was no significant decrease in insulin concentrations with overall phytoestrogen supplementation, the pooled mean difference in changes was -0.99 pmol/L (95% CI: -4.65, 2.68 pmol/L). However, the results of RCTs varied by type of phytoestrogens: soy-derived isoflavones and genistein improved glucose homeostasis, whereas isoflavone mix and daidzein had no effect or were associated with an adverse glycemic profile. Higher dietary phytoestrogen intake was associated with a 10% lower risk of developing T2D in observational studies (pooled RR: 0.90; 95% CI: 0.85, 0.96; for the highest compared with the lowest quantiles). Results were similar when the analyses were restricted to only medium- and high-quality studies. Overall, phytoestrogens may have a positive influence on glycemia and could be used for diabetes prevention in women. However, for some individual types of phytoestrogens, such as mixed isoflavones, caution is needed in recommending their use in women, because their use could lead to an adverse glycemic profile in women.

Characterization of changes of pain behavior and signal transduction system in food-deprived mice.
Jang SP, Park SH, Jung JS, Lee HJ, Hong JW, Lee JY, Suh HW.
Animal Cells Syst (Seoul). 2018 Jun 28;22(4):227-233. doi: 10.1080/19768354.2018.1490348. eCollection 2018.
PMID: 30460102
https://www.tandfonline.com/doi/pdf/10.1080/19768354.2018.1490348?needAccess=true
Abstract
Fasting in general causes several metabolic changes. In the present study, we examined the possible changes of several types of nociception during the food deprivation were investigated in mice. After the mice were forced into the fasting for 12, 24, or 48 h, the changes of nociception were measured by the tail-flick, writhing, formalin or von-frey tests. We found that the nociceptive behavior induced by intraperitoneally (i.p.) administered acetic acid (writhing response) or intraplantar injection of 5% formalin into the hind-paw were reduced in fasted group. In addition, the tail-flick response and threshold for nociception in mechanical von-frey test were also elevated in fasted group. Moreover, the p-CREB and p-ERK levels in the dorsal root ganglia (DRG) and the spinal cord were reduced in food-deprived group. Furthermore, p-AMPKα1 expressions in DRG and the spinal cord were up-regulated, whereas p-mTOR in DRG and the spinal cord was down-regulated in food-deprived group. Our results suggest that the chemical, mechanical, and thermal nociceptions appear to be reduced in a food-deprived mouse group. Additionally, reduction of nociception in food-deprived group appears to be closely associated with the expressions of several signal transduction molecules such as ERK, CREB, AMPKα1 and mTOR proteins in DRG and the spinal cord.
KEYWORDS:
Nociception; dorsal root ganglia; food deprivation; pain; signal transduction

Total polyphenol intake, polyphenol subtypes and incidence of cardiovascular disease: The SUN cohort study.
Mendonça RD, Carvalho NC, Martin-Moreno JM, Pimenta AM, Lopes ACS, Gea A, Martinez-Gonzalez MA, Bes-Rastrollo M.
Nutr Metab Cardiovasc Dis. 2018 Oct 4. pii: S0939-4753(18)30295-3. doi: 10.1016/j.numecd.2018.09.012. [Epub ahead of print]
PMID: 30459074
Abstract
BACKGROUND AND AIMS:
Polyphenol-rich diets have been associated with reduced risk of cardiovascular disease (CVD). However, few prospective epidemiological studies have examined the relationship between classes of ingested polyphenols and risk of CVD. Our aim was to evaluate the association between polyphenol intake and risk of major cardiovascular events in a prospective Spanish cohort.
METHODS AND RESULTS:
We included 17,065 university graduates (60.7% women, mean age: 37.2 years, age range: 20-89) followed-up for a mean of 10.1 years. Polyphenol intake was assessed at baseline using a validated semi-quantitative 136-item food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for incident cardiovascular events (myocardial infarction, stroke or cardiovascular death). Cherries, chocolate, coffee, apples, and olives were the major sources of variability in polyphenol intake. Participants with higher flavonoids intake (fifth quintile) had a 47% lower incidence of cardiovascular events compared to those in the lowest quintile (HR: 0.53, 95% CI: 0.29-0.98; P for trend = 0.09) after adjusting for potential confounders. The results were non-significant for other polyphenol types.
CONCLUSION:
The intake of flavonoids showed an inverse association with risk of cardiovascular events in a prospective cohort of Spanish middle-aged adult university graduates.
KEYWORDS:
Cardiovascular disease; Dietary polyphenols; Flavonoids; Prospective studies; SUN cohort

Long-term weight loss maintenance, sex steroid hormones, and sex hormone-binding globulin.
Duggan C, Tapsoba JD, Stanczyk F, Wang CY, Schubert KF, McTiernan A.
Menopause. 2018 Nov 19. doi: 10.1097/GME.0000000000001250. [Epub ahead of print]
PMID: 30461557
Abstract
OBJECTIVE:
We tested the effects of weight loss on serum estradiol, estrone, testosterone, and sex hormone-binding globulin (SHBG) in overweight/obese women 18 months after completing a year-long, 4-arm, randomized-controlled dietary weight loss and/or exercise trial.
METHODS:
From 2005 to 2008, 439 overweight/obese, postmenopausal women (BMI >25 kg/m), 50 to 75 years, were randomized to a year-long intervention: diet (reduced calorie, 10% weight loss, N = 118), exercise (225 min/wk moderate-to-vigorous activity, N = 117), combined diet + exercise (N = 117), or control (N = 87). At 12 months, 399 women provided blood; of these, 156 returned at 30 months and gave a blood sample. Hormones and SHBG were measured by immunoassay. Changes were compared using generalized estimating equations, adjusting for confounders.
RESULTS:
At 30 months, participants randomized to the diet + exercise intervention had statistically significant increases in SHBG levels versus controls (P = 0.001). There was no statistically significant change in SHBG in the exercise or diet intervention arms. Hormone levels did not vary by intervention arm from baseline to 30 months. Participants who maintained weight loss at 30 months had statistically significantly greater decreases in free estradiol and free testosterone (Ptrend = 0.02 and Ptrend = 0.04, respectively) and increases in SHBG (Ptrend < 0.0001) versus those who did not have sustained weight loss. Levels of other analytes did not vary by weight loss at 30 months.
CONCLUSIONS:
Sustained weight loss results in reductions in free estradiol and testosterone and increases in SHBG 18-month post-intervention.

Hypertension and longevity: role of genetic polymorphisms in renin-angiotensin-aldosterone system and endothelial nitric oxide synthase.
Pereira da Silva A, Matos A, Aguiar L, Ramos-Marques N, Ribeiro R, Gil Â, Gorjão-Clara J, Bicho M.
Mol Cell Biochem. 2018 Nov 20. doi: 10.1007/s11010-018-3470-1. [Epub ahead of print]
PMID: 30460536
Abstract
Hypertension (HT), a common age-related disorder, is an important risk factor for cardiovascular disease. This study aims to identify the prevalence of HT in Portuguese centenarians and evaluate whether gene polymorphisms encoding key molecules in blood pressure (BP) regulation are associated with longevity. There were recruited 253 centenarians (100.26 ± 1.98 years) and 268 control subjects (67.51 ± 3.25 years). Hypertension (ESH/ESC2013 and JNC8) and diabetes (WHO) were evaluate. Genetic polymorphisms of renin-angiotensin-aldosterone system (RAAS) and NOS3 were determined. The prevalence of HT among centenarians was 64.4% and the majority (58.9%) were controlled, differing from control group both on frequency (P < 0.001) and on their control (P < 0.001). We found that HT is a risk factor for not achieving longevity (OR 2.531, 95% CI 1.688-3.793, P < 0.001), the same for diabetes (OR 5.669 95% CI 2.966-10.835, P < 0.001), and male gender (OR 2.196, 95% CI 1.493-3.29, P < 0.001). Hypertension, adjusted for gender and diabetes, was independent risk factor anti-longevity (OR 2.007, 95% CI 1320-3.052, P = 0.001). The ACE_D and NOS3_G alleles were more frequent in centenarians compared to controls (P < 0.001, both cases). ACE_II and NOS3_TT genotypes, adjusted for BP, gender and diabetes, increased risk in 3.748 (95% CI 1.887-7.444) and 2.533 (95% CI 1.483-4.327), respectively, in relation to ACE_DD (P < 0.001) and NOS3_GG (P = 0.001), against longevity. Our findings suggest that the prevalence of hypertension was lower in Portuguese centenarians than in the elderly, reinforcing the importance of better cardiovascular risk profiles to achieve longevity even in the presence of genetic condition.
KEYWORDS:
ACE; Centenarians; Genetic polymorphism; Hypertension; Longevity; NOS3

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Fruit and Vegetable Consumption and Their Polyphenol Content Are Inversely Associated with Sleep Duration: Prospective Associations from the UK Women's Cohort Study.
Noorwali E, Hardie L, Cade J.
Nutrients. 2018 Nov 20;10(11). pii: E1803. doi: 10.3390/nu10111803.
PMID: 30463296
https://www.mdpi.com/2072-6643/10/11/1803/htm
Abstract
This study aims to investigate the prospective associations between fruit and vegetable (FV) intakes and their polyphenol content with subsequent sleep duration in UK women. In this study, 13,958 women with ~4 years of follow-up in the UK Women's Cohort Study were included in the analyses. FV intakes were assessed at baseline using a food frequency questionnaire (FFQ), and average hours of sleep per day were self-reported in follow-up. Polyphenol intake was calculated by matching FV items from the FFQ with the Phenol-Explorer database. Linear regression models, adjusting for confounders, were used for the analyses. Consuming an additional portion of apples, kiwi, oranges, pineapple, and 100% pure juice were associated with shorter sleep. Similarly, an additional portion of cabbage, celery, aubergine, olives, and peppers were inversely associated with sleep duration. An additional gram of total polyphenols was associated with shorter sleep by 18 min (99% CI -31 to -4, p < 0.001). FV consumption and total polyphenol content were inversely associated with sleep duration; however, effect sizes were small, and polyphenol classes from FV intakes were not associated with sleep duration. Future intervention studies considering the time of FV consumption in relation to sleep are needed to clarify the underlying mechanisms.
KEYWORDS:
fruits and vegetables; polyphenols; sleep

Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children.
Vorilhon P, Arpajou B, Vaillant Roussel H, Merlin É, Pereira B, Cabaillot A.
Eur J Clin Pharmacol. 2018 Nov 21. doi: 10.1007/s00228-018-2601-7. [Epub ahead of print] Review.
PMID: 30465062
Abstract
PURPOSE:
Upper respiratory tract infection (URTI) is a common infection in children, generally caused by viral respiratory infection. Vitamin C is currently proposed as prophylaxis for URTI. The purpose of this study was to assess the effectiveness of vitamin C administration in children for the prevention and reduced duration of URTI through a systematic literature review.
METHODS:
Review of the literature conducted between October 2017 and January 2018 in the main medical databases (CENTRAL, Medline and Embase) and by a gray literature approach. The selection criteria were: double-blind randomized controlled trials (RCTs) comparing vitamin C use to placebo in children aged 3 months to 18 years without chronic infection. Efficacy was assessed in terms of incidence, duration and severity of symptoms of URTI. A meta-analysis was conducted where possible.
RESULTS:
Eight RCTs, including 3135 children aged 3 months to 18 years, were selected. Quantitative analysis showed no difference between vitamin C administration and placebo (odds ratio = 0.75, 95% CI [0.54-1.03], p = 0.07, I2 = 74%). Vitamin C administration was found to decrease the duration of URTI by 1.6 days (standardized mean differences = -0.30 [-0.53; -0.08], p = 0.009, I2 = 70%). Children under 6 years of age benefit from more effective vitamin C supplementation associated with echinacea. No serious adverse events were reported.
CONCLUSIONS:
Although no preventive effects were found, vitamin C intake reduced the duration of URTI. Considering the frequency of URTI, the inappropriate prescription of antibiotics, and the safe nature of vitamin C, its supplementation is justified, especially in children under 6 years of age and those who present a high frequency of URTI. There is a sound rationale for further trials with greater statistical power among children of this age.
KEYWORDS:
Adolescents; Infants; Systematic review; Upper respiratory tract infection; Vitamin C

Long-term intake of vegetables and fruits and subjective cognitive function in US men.
Yuan C, Fondell E, Bhushan A, Ascherio A, Okereke OI, Grodstein F, Willett WC.
Neurology. 2018 Nov 21. pii: 10.1212/WNL.0000000000006684. doi: 10.1212/WNL.0000000000006684. [Epub ahead of print]
PMID: 30464030
https://sci-hub.tw/10.1212/WNL.0000000000006684
Abstract
OBJECTIVE:
To evaluate the prospective association of long-term intake of vegetables and fruits with late-life subjective cognitive function (SCF).
METHODS:
Among 27,842 men with a mean age of 51 years in 1986, we used multinomial logistic regression to examine the relation of vegetable and fruit consumption to future SCF. Average dietary intake was calculated from 5 repeated food frequency questionnaires collected every 4 years until 2002. SCF score was assessed twice (2008 and 2012) using a 6-item questionnaire; validity was supported by strong associations with APO ε4 genotype. We categorized the average of the 2 scores as good, moderate, and poor SCF.
RESULTS:
Higher intakes of total vegetables, total fruits, and fruit juice were each significantly associated with lower odds of moderate or poor SCF after controlling for major nondietary factors and total energy intake. The association with total fruit intake was weaker after further adjusting for major dietary factors. In this model, the multivariate odds ratios (95% confidence intervals) for vegetable intake (top vs bottom quintile) were 0.83 (0.76-0.92), p trend <0.001 for moderate SCF and 0.66 (0.55-0.80), p trend <0.001 for poor SCF. For orange juice, compared to <1 serving/mo of intake, daily consumption was associated with a substantially lower odds of poor SCF (0.53 [0.43-0.67], p trend <0.001). Higher consumption of vegetables and fruits 18 to 22 years before SCF assessment was associated with lower odds of poor SCF independent of more proximal intake.
CONCLUSION:
Our findings support a long-term beneficial role of vegetable, fruit, and orange juice consumption on SCF.

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Role of rs670 variant of APOA1 gene on metabolic response after a high fat vs. a low fat hypocaloric diets in obese human subjects.
de Luis D, Izaola O, Primo D, Aller R.
J Diabetes Complications. 2018 Nov 3. pii: S1056-8727(18)30959-0. doi: 10.1016/j.jdiacomp.2018.10.015. [Epub ahead of print]
PMID: 30467071
https://sci-hub.tw/https://linkinghub.elsevier.com/retrieve/pii/S1056872718309590
Abstract
BACKGROUND & AIMS:
A common G-to-A transition located 75 base pairs upstream (rs670) from transcription start site of the APOA1 gene has been related with some metabolic parameters. Our aim was to analyze the effects of rs670 APOA1 gene polymorphism on lipid profile and metabolic changes after two different hypocaloric diets.
METHODS:
282 obese subjects were randomly allocated during 12 weeks (Diet HF - high fat diet vs. Diet LF - low fat diet). Anthropometric and biochemical status were evaluated.
RESULTS:
Body mass index, weight, fat mass, waist circumference, systolic blood pressure, leptin levels and waist circumference decreased in all patients in average after both diets. In A allele carriers after 12 weeks with both diets, insulin levels (Delta diet HF: -5.3 + 1.2 UI/L; P = 0.02 and Delta diet LF: -5.8 + 1.3 UI/L; P = 0.02) and HOMA-IR (Delta diet HF: -2.9 + 0.8 units; P = 0.01 and Delta diet LF: -2.2 + 0.9 units; P = 0.03) improved in a significant way. With the low fat diet, A allele carriers showed a statistical improvement in HDL-cholesterol levels (Delta: 4 + 1 mg/dl; P = 0.03).
CONCLUSIONS:
Our study showed the association of rs670 ApoA1 polymorphism with a decrease of insulin resistance induced by both diets and provided additional evidence on HDL-cholesterol increase after a LF hypocaloric diet in A allele carriers.
KEYWORDS:
Adipokines; ApoA1; Dietary fat; Hypocaloric diet; Rs670

Why salad is so overrated
By Tamar Haspel August 23, 2015
https://www.washingtonpost.com/lifestyle/food/why-salad-is-so-overrated/2015/08/21/ecc03d7a-4677-11e5-8ab4-c73967a143d3_story.html?noredirect=on&utm_term=.043af05d5ffa
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Is salad a luxury food? One writer argues it's time to rethink leafy greens
It's a resource-intensive crop that isn't very nutritious, says writer Tamar Haspel
CBC Radio · November 22
https://www.cbc.ca/radio/thecurrent/the-current-for-november-22-2018-1.4915910/is-salad-a-luxury-food-one-writer-argues-it-s-time-to-rethink-leafy-greens-1.4916002

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Effects of fatty and lean fish intake on stroke risk: a meta-analysis of prospective cohort studies.
Qin ZZ, Xu JY, Chen GC, Ma YX, Qin LQ.
Lipids Health Dis. 2018 Nov 23;17(1):264. doi: 10.1186/s12944-018-0897-z.
PMID: 30470232
Abstract
BACKGROUND:
Fish intake has been postulated to reduce the risk of stroke. However, whether the beneficial effect of fish are mainly linked to fat content, as a source of omega-3 polyunsaturated fatty acids, remains unclear. We conducted a meta-analysis to compare the effect of fatty and lean fish intake on stroke risk.
METHODS:
We performed a literature search on four database (PubMed, Embase, Scopus, and Cochrane Library) through February 1, 2018 to identify prospective studies of fatty and lean fish in relation to stroke risk. A random-effects model was used to calculate the summary estimates.
RESULTS:
We identified five prospective studies, including 7 comparisons for fatty fish intake and 5 comparisons for lean fish intake. Compared with the highest category of intake with lowest category, the summary relative risk was 0.88 [95% confidence interval (CI), 0.74-1.04] for fatty fish intake and 0.81 (95% CI, 0.67-0.99) for lean fish intake. No heterogeneity across studies and publication bias were observed.
CONCLUSION:
Our findings demonstrated that fatty and lean fish intake has beneficial effects on stroke risk, especially lean fish intake. Additional prospective studies are necessary to confirm these observations.
KEYWORDS:
Fatty fish; Lean fish; Meta-analysis; Stroke risk
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Fish Consumption and Stroke Risk: A Meta-Analysis of Prospective Cohort Studies.
Zhao W, Tang H, Yang X, Luo X, Wang X, Shao C, He J.
J Stroke Cerebrovasc Dis. 2018 Nov 20. pii: S1052-3057(18)30616-5. doi: 10.1016/j.jstrokecerebrovasdis.2018.10.036. [Epub ahead of print]
PMID: 30470619
Abstract
BACKGROUND:
Inconsistent results of the association between fish consumption and stroke risk have been indicated in previous epidemiological studies. Therefore, we performed a meta-analysis of prospective cohort studies to estimate the impact of fish consumption on stroke risk.
METHODS:
The PubMed and EMBASE databases were searched through a computer search. Prospective cohort studies satisfying predetermined inclusion criterion were included. Random-effect model was adopted in this meta-analysis. Analysis of subgroup, sensitivity, publication bias, dose-response, power, and quality of evidence was also conducted.
RESULTS:
Thirty one publications including 33 independent prospective cohort studies were identified in this meta-analysis. In the primary analysis of the highest versus lowest categories of fish consumption, pooled results indicated that a significant trend toward an inverse association between fish intake and stroke risk (HR = .90, 95% confidence interval [CI] .85-.96). Further subgroup analyses indicated an inverse association was more pronounced in the group of hemorrhagic stroke (HR=.88, 95% CI .80-.96), female (HR =.83, 95% CI .75-.92), and Asia-Pacific (HR = .87, 95% CI .80-.95). Both the funnel plot and Egger tests suggested no evidence of publication bias. Dose-response analysis showed a linear relationship between fish intake and stroke and the risk of stroke decreased by 2%-12% with increasing intake of fish up to 100-700 g/week. According to the NutriGrade scoring system, the level of metaevidence quality was moderate.
CONCLUSIONS:
Based on current evidence from prospective cohort studies, we concluded that fish consumption was associated with a decreased risk of stroke.
KEYWORDS:
Stroke; fish; meta-analysis; risk

The effect of diet on BPH, LUTS and ED.
ElJalby M, Thomas D, Elterman D, Chughtai B.
World J Urol. 2018 Nov 23. doi: 10.1007/s00345-018-2568-0. [Epub ahead of print]
PMID: 30470872
https://sci-hub.tw/10.1007/s00345-018-2568-0
Abstract
OBJECTIVE:
Benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are common conditions that increase in the aging population. Several environmental factors have been linked to the development and progression of BPH and ED. Several studies have shown potential direct and indirect influences of several micronutrients and macronutrients on the risk of developing these conditions. We reviewed the available published literature of the effect of diet on BPH and ED.
METHODS:
A comprehensive search was performed to identify studies that evaluated how diet affected males with BPH and ED. Searches were run on July 5th, 2018 in the following databases: Ovid MEDLINE®; Ovid EMBASE; and The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL). There were no language restrictions, publication date restrictions, or article type restrictions on the search strategy.
RESULTS:
We retrieved a total of 1670 results across all databases. After removing any duplicated results, 2 independent reviewers screened a total of 1325 citations. A total of 35 articles were selected for inclusion in this review. Diet is an important factor affecting the risk of development of BPH and ED. Several studies have shown the effect of dietary interventions for BPH and ED.
DISCUSSION:
A better understanding diet and its relative effects on the development, treatment and prevention of these diseases are an important area of further research for the given aging male population.
KEYWORDS:
BPH; Diet; ED; LUTS

Effect of intermittent compared to continuous energy restriction on weight loss and weight maintenance after 12 months in healthy overweight or obese adults.
Headland ML, Clifton PM, Keogh JB.
Int J Obes (Lond). 2018 Nov 23. doi: 10.1038/s41366-018-0247-2. [Epub ahead of print]
PMID: 30470804
Abstract
BACKGROUND AND OBJECTIVE:
Intermittent energy restriction (IER) is an alternative to continuous energy restriction (CER) for weight loss. There are few long-term trials comparing efficacy of these methods. The objective was to compare the effects of CER to two forms of IER; a week-on-week-off energy restriction and a 5:2 program, during which participants restricted their energy intake severely for 2 days and ate as usual for 5 days, on weight loss, body composition, blood lipids, and glucose.
SUBJECTS AND METHODS:
A one-year randomized parallel trial was conducted at the University of South Australia, Adelaide, Australia. Participants were 332 overweight and obese adults, ages 18-72 years, who were randomized to 1 of 3 groups: CER (4200 kJ/day for women and 5040 kJ/day for men), week-on-week-off energy restriction (alternating between the same energy restriction as the continuous group for one week and one week of habitual diet), or 5:2 (2100 kJ/day on modified fast days each week for women and 2520 kJ/day for men, the 2 days of energy restriction could be consecutive or non-consecutive). Primary outcome was weight loss, and secondary outcomes were changes in body composition, blood lipids, and glucose.
RESULTS:
For the 146 individuals who completed the study (124 female, 22 male, mean BMI 33 kg/m2) mean weight loss, and body fat loss at 12 months was similar in the three intervention groups, -6.6 kg for CER, -5.1 kg for the week-on, week-off and -5.0 kg for 5:2 (p = 0.2 time by diet). Discontinuation rates were not different (p = 0.4). HDL-cholesterol rose (7%) and triglycerides decreased (13%) at 12 months with no differences between groups. No changes were seen for fasting glucose or LDL-cholesterol.
DISCUSSION AND CONCLUSION:
The two forms of IER were not statistically different for weight loss, body composition, and cardiometabolic risk factors compared to CER.

Calorie Restriction Mimetics: Upstream-Type Compounds for Modulating Glucose Metabolism.
Shintani H, Shintani T, Ashida H, Sato M.
Nutrients. 2018 Nov 22;10(12). pii: E1821. doi: 10.3390/nu10121821. Review.
PMID: 30469486
https://www.mdpi.com/2072-6643/10/12/1821/htm
Abstract
Calorie restriction (CR) can prolong the human lifespan, but enforcing long-term CR is difficult. Therefore, a compound that reproduces the effect of CR without CR is needed. In this review, we summarize the current knowledge on compounds with CR mimetic (CRM) effects. More than 10 compounds have been listed as CRMs, some of which are conventionally categorized as upstream-type CRMs showing glycolytic inhibition, while the others are categorized as downstream-type CRMs that regulate or genetically modulate intracellular signaling proteins. Among these, we focus on upstream-type CRMs and propose their classification as compounds with energy metabolism inhibition effects, particularly glucose metabolism modulation effects. The upstream-type CRMs reviewed include chitosan, acarbose, sodium-glucose cotransporter 2 inhibitors, and hexose analogs such as 2-deoxy-d-glucose, d-glucosamine, and d-allulose, which show antiaging and longevity effects. Finally, we discuss the molecular definition of upstream-type CRMs.
KEYWORDS:
2-deoxy-d-glucose; SGLT2 inhibitor; acarbose; antiaging; calorie restriction mimetics; chitosan; d-allulose; d-glucosamine; glucose metabolism modulation; lifespan extension

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Alcohol drinking patterns and liver cirrhosis risk: analysis of the prospective UK Million Women Study.
Simpson RF, Hermon C, Liu B, Green J, Reeves GK, Beral V, Floud S; Million Women Study Collaborators.
Lancet Public Health. 2018 Nov 21. pii: S2468-2667(18)30230-5. doi: 10.1016/S2468-2667(18)30230-5. [Epub ahead of print]
PMID: 30472032
Abstract
BACKGROUND:
Alcohol is a known cause of cirrhosis, but it is unclear if the associated risk varies by whether alcohol is drunk with meals, or by the frequency or type of alcohol consumed. Here we aim to investigate the associations between alcohol consumption with meals, daily frequency of consumption, and liver cirrhosis.
METHODS:
The Million Women Study is a prospective study that includes one in every four UK women born between 1935 and 1950, recruited between 1996 and 2001. In 2001 (IQR 2000-03), the participants reported their alcohol intake, whether consumption was usually with meals, and number of days per week it was consumed. Cox regression analysis yielded adjusted relative risks (RRs) for incident cirrhosis, identified by follow-up through electronic linkage to routinely collected national hospital admission, and death databases.
FINDINGS:
During a mean of 15 years (SD 3) of follow-up of 401 806 women with a mean age of 60 years (SD 5), without previous cirrhosis or hepatitis, and who reported drinking at least one alcoholic drink per week, 1560 had a hospital admission with cirrhosis (n=1518) or died from the disease (n=42). Cirrhosis incidence increased with amount of alcohol consumed (≥15 drinks [mean 220 g of alcohol] vs one to two drinks [mean 30 g of alcohol] per week; RR 3·43, 95% CI 2·87-4·10; p<0·0001). About half of the participants (203 564 of 401 806) reported usually drinking with meals and, after adjusting for amount consumed, cirrhosis incidence was lower for usually drinking with meals than not (RR 0·69, 0·62-0·77; p<0·0001; wine-only drinkers RR 0·69, 0·56-0·85; all other drinkers RR 0·72, 0·63-0·82). Among 175 618 women who consumed seven or more drinks per week, cirrhosis incidence was greater for daily consumption than non-daily consumption (adjusted RR 1·61, 1·40-1·85; p<0·0001). Daily consumption, together with not drinking with meals, was associated with more than a doubling of cirrhosis incidence (adjusted RR 2·47, 1·96-3·11; p<0·0001).
INTERPRETATION:
In middle-aged women, cirrhosis incidence increases with total alcohol intake, even at moderate levels of consumption. For a given weekly intake of alcohol, this excess incidence of cirrhosis is higher if consumption is usually without meals, or with daily drinking.

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Metformin induces significant reduction of body weight, total cholesterol and LDL levels in the elderly - A meta-analysis.
Solymár M, Ivic I, Pótó L, Hegyi P, Garami A, Hartmann P, Pétervári E, Czopf L, Hussain A, Gyöngyi Z, Sarlós P, Simon M, Mátrai P, Bérczi B, Balaskó M.
PLoS One. 2018 Nov 26;13(11):e0207947. doi: 10.1371/journal.pone.0207947. eCollection 2018.
PMID: 30475888
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207947
Abstract
BACKGROUND:
Metformin is the first-choice drug for patients with Type 2 diabetes, and this therapy is characterized by being weight neutral. However, in the elderly an additional unintentional weight loss could be considered as an adverse effect of the treatment.
OBJECTIVES:
We aimed to perform a meta-analysis of placebo-controlled studies investigating the body weight changes upon metformin treatment in participants older than 60 years.
MATERIALS AND METHODS:
PubMed, EMBASE and the Cochrane Library were searched. We included at least 12 week-long studies with placebo control where the mean age of the metformin-treated patients was 60 years or older and the body weight changes of the patients were reported. We registered our protocol on PROSPERO (CRD42017055287).
RESULTS:
From the 971 articles identified by the search, 6 randomized placebo-controlled studies (RCTs) were included in the meta-analysis (n = 1541 participants). A raw difference of -2.23 kg (95% CI: -2.84 --1.62 kg) body weight change was detected in the metformin-treated groups as compared with that of the placebo groups (p<0.001). Both total cholesterol (-0.184 mmol/L, p<0.001) and LDL cholesterol levels (-0.182 mmol/L, p<0.001) decreased upon metformin-treatment.
CONCLUSIONS:
Our meta-analysis of RCTs showed a small reduction of body weight together with slight improvement of the blood lipid profile in patients over 60 years. With regard to the risk of unintentional weight loss, metformin seems to be a safe agent in the population of over 60 years. Our results also suggest that metformin treatment may reduce the risk of major coronary events (-4-5%) and all-cause mortality (-2%) in elderly diabetic populations.

Coffee consumption and total mortality in a Mediterranean prospective cohort.
Navarro AM, Martinez-Gonzalez MÁ, Gea A, Grosso G, Martín-Moreno JM, Lopez-Garcia E, Martin-Calvo N, Toledo E.
Am J Clin Nutr. 2018 Nov 1;108(5):1113-1120. doi: 10.1093/ajcn/nqy198.
PMID: 30475964
Abstract
BACKGROUND:
The relation of coffee consumption with total mortality is controversial, because the available evidence is still inconsistent.
OBJECTIVE:
This study aimed to assess this association in a highly educated, middle-aged Mediterranean cohort.
DESIGN:
We analyzed data from 201,055 person-years of follow-up arising from 19,888 participants. Coffee consumption was obtained at baseline with the use of a previously validated semiquantitative food-frequency questionnaire. Information on mortality was ascertained by permanent contact with the "Seguimiento Universidad de Navarra" (SUN) participants and their families, postal authorities, and consultation of the National Death Index. We used Cox regression models to estimate HRs and 95% CIs for mortality according to baseline total coffee consumption adjusted for potential confounders. Sex, age, and baseline adherence to the Mediterranean diet were considered as potential effect modifiers.
RESULTS:
Among the 19,888 participants, 337 died. Overall, in the multivariable adjusted analysis, we found a 22% lower risk of all-cause mortality for each 2 additional cups of total coffee per day (HR: 0.78; 95% CI: 0.66, 0.93). This association was stronger for participants aged ≥55 y (HR: 0.67; 95% CI: 0.52, 0.86) than for younger participants, who showed no significant association (P-interaction = 0.002).
CONCLUSION:
In a Mediterranean cohort, we found an inverse linear association between total coffee consumption and the risk of all-cause mortality that was strongest among participants older than 54 y.

Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies.
Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T.
Am J Clin Nutr. 2018 Nov 1;108(5):1069-1091. doi: 10.1093/ajcn/nqy097.
PMID: 30475962
https://watermark.silverchair.com/nqy097.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAkIwggI-BgkqhkiG9w0BBwagggIvMIICKwIBADCCAiQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMHrmYeAt8k8ZpyliIAgEQgIIB9TAKcYYTSL9NkoXltT8h-052EOAFey5nvWHfvUatPlqG32DF-mWhc_r2Mg73oTyxc3vKejLNKrpLFwxeDf3kpMdEI-iue8KGe9xcT_rWc00UB3nhbv0c5lIDPBGEQXdi5JLnuazFSJ7UKtoxqmn2HNpC_2OIu-UcRLhgGeT1CHqc8lckWdE2R4C68iqIMC-GYk0RCC_nJfV1avymV00pCvL0kO86x52EF2q1m-AnZv6fmxW5-G8OfD9eM2JjOP4iH4dqd_Vdiv2hpc1BCVfuZlnctek7AwgpexyMt4UFrl3IBwsRXydh4xENzolHtqIMY2wSdn_RsISBwIHStsfO4enNqrvmst--tcJoKY5rGy5z_zlnYvR5lrHV4Pv79YbP3vpLhbXiQHBk1XAJDkHJ1M_PFlVQpGlg1ydIVusk7N4l-wru9p4E2uJTrr7dx9_RE_MKLgAGxD6NUkc6DFzsNpXhvIO-nIIX-m9KRi_d0ZleP2mAI6Dcuu6s5ovxX7k1BLoKfAZYdsAmIzmq2rNHyI-R1EbiVGp9L4TjXjv0hG6gbcwqFwaZonYj8Qn-AdJmCytb_SAClkFzRX3yGftA3NUzqKHU2gPdn0HjcK2sIeDBzVZsrX_B7deUT_1rluiJphP82CY3zGm0zJbUEYUubswnrCQHCg
Abstract
BACKGROUND:
High dietary intake or blood concentrations (as biomarkers of dietary intake) of vitamin C, carotenoids, and vitamin E have been associated with reduced risk of cardiovascular disease, cancer, and mortality, but these associations have not been systematically assessed.
OBJECTIVE:
We conducted a systematic review and meta-analysis of prospective studies of dietary intake and blood concentrations of vitamin C, carotenoids, and vitamin E in relation to these outcomes.
DESIGN:
We searched PubMed and Embase up to 14 February 2018. Summary RRs and 95% CIs were calculated with the use of random-effects models.
RESULTS:
Sixty-nine prospective studies (99 publications) were included. The summary RR per 100-mg/d increment of dietary vitamin C intake was 0.88 (95% CI: 0.79, 0.98, I2 = 65%, n = 11) for coronary heart disease, 0.92 (95% CI: 0.87, 0.98, I2 = 68%, n = 12) for stroke, 0.89 (95% CI: 0.85, 0.94, I2 = 27%, n = 10) for cardiovascular disease, 0.93 (95% CI: 0.87, 0.99, I2 = 46%, n = 😎 for total cancer, and 0.89 (95% CI: 0.85, 0.94, I2 = 80%, n = 14) for all-cause mortality. Corresponding RRs per 50-μmol/L increase in blood concentrations of vitamin C were 0.74 (95% CI: 0.65, 0.83, I2 = 0%, n = 4), 0.70 (95% CI: 0.61, 0.81, I2 = 0%, n = 4), 0.76 (95% CI: 0.65, 0.87, I2 = 56%, n = 6), 0.74 (95% CI: 0.66, 0.82, I2 = 0%, n = 5), and 0.72 (95% CI: 0.66, 0.79, I2 = 0%, n = 8). Dietary intake and/or blood concentrations of carotenoids (total, β-carotene, α-carotene, β-cryptoxanthin, lycopene) and α-tocopherol, but not dietary vitamin E, were similarly inversely associated with coronary heart disease, stroke, cardiovascular disease, cancer, and/or all-cause mortality.
CONCLUSIONS:
Higher dietary intake and/or blood concentrations of vitamin C, carotenoids, and α-tocopherol (as markers of fruit and vegetable intake) were associated with reduced risk of cardiovascular disease, total cancer, and all-cause mortality. These results support recommendations to increase fruit and vegetable intake, but not antioxidant supplement use, for chronic disease prevention.


Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults: a systematic review and meta-analysis.
Ten Haaf DSM, Nuijten MAH, Maessen MFH, Horstman AMH, Eijsvogels TMH, Hopman MTE.
Am J Clin Nutr. 2018 Nov 1;108(5):1043-1059. doi: 10.1093/ajcn/nqy192.
PMID: 30475963
Abstract
BACKGROUND:
Increasing protein intake has been suggested as an effective strategy to ameliorate age-related loss of muscle mass and strength. Current reviews assessing the effect of protein supplementation are strongly influenced by the inclusion of studies with frail older adults.
OBJECTIVES:
We assessed the effect of protein supplementation on lean body mass, muscle strength, and physical performance in exclusively nonfrail community-dwelling older adults. Moreover, we assessed the superior effects of protein supplementation during concomitant resistance exercise training on muscle characteristics.
DESIGN:
A systematic literature search was conducted on PubMed, Embase, and Web of Science up to 15 May 2018. We included randomized controlled trials that assessed the effect of protein supplementation on lean body mass, muscle thigh cross-sectional area, muscle strength, gait speed, and chair-rise ability and performed random-effects meta-analyses.
RESULTS:
Data from 36 studies with 1682 participants showed no significant effects of protein supplementation on changes in lean body mass [standardized mean difference (SMD): 0.11; 95% CI: -0.06, 0.28], handgrip strength (SMD: 0.58; 95% CI: -0.08, 1.24), lower extremity muscle strength (SMD: 0.03; 95% CI: -0.20, 0.27), gait speed (SMD: 0.41; 95% CI: -0.04, 0.85), or chair-rise ability (SMD: 0.10; 95%: CI -0.08, 0.28) compared with a control condition in nonfrail community-dwelling older adults. Moreover, no superior effects of protein supplementation were found during concomitant resistance exercise training on muscle characteristics.
CONCLUSIONS:
Protein supplementation in nonfrail community-dwelling older adults does not lead to increases in lean body mass, muscle cross-sectional area, muscle strength, or physical performance compared with control conditions; nor does it exert superior effects when added to resistance exercise training. Habitual protein intakes of most study participants were already sufficient, and protein interventions differed in terms of type of protein, amount, and timing. Future research should clarify what specific protein supplementation protocol is beneficial for nonfrail community-dwelling older adults with low habitual protein intake.

Intake of protein-rich foods in relation to outcomes of infertility treatment with assisted reproductive technologies.
Nassan FL, Chiu YH, Vanegas JC, Gaskins AJ, Williams PL, Ford JB, Attaman J, Hauser R, Chavarro JE; EARTH Study Team.
Am J Clin Nutr. 2018 Nov 1;108(5):1104-1112. doi: 10.1093/ajcn/nqy185.
PMID: 30475972
Abstract
BACKGROUND:
Some dietary factors have been linked to outcomes of infertility treatment with assisted reproductive technology (ART), but the role of intake of meats and other protein-rich foods remains unclear.
OBJECTIVE:
The aim of this manuscript was to study the relation between preconception intake of meat and other protein-rich foods and outcomes of infertility treatment with ART.
DESIGN:
A total of 351 women enrolled in a prospective cohort at the Massachusetts General Hospital Fertility Center and underwent 598 ART cycles for infertility treatment. Meat intake was assessed with a validated food-frequency questionnaire, and ART outcomes were abstracted from electronic medical records. We estimated the associations between intake of protein-rich foods (meats, eggs, beans, nuts, and soy) and the outcome of live birth per initiated cycle using generalized linear mixed models.
RESULTS:
The average total meat intake was 1.2 servings/d, with most coming from poultry (35%), fish (25%), processed meat (22%), and red meat (17%). Fish intake was positively related to the proportion of cycles resulting in live birth. The multivariable-adjusted probabilities of live birth for women in increasing quartiles of fish intake were 34.2% (95% CI: 26.5%, 42.9%), 38.4% (95% CI: 30.3%, 47.3%), 44.7% (95% CI: 36.3%, 53.4%), and 47.7% (95% CI: 38.3%, 57.3%), respectively (P-trend = 0.04). In the estimated substitution analyses, the ORs of live birth associated with increasing fish intake by 2 servings/wk were 1.54 (95% CI: 1.14, 2.07) when fish replaced any other meat, 1.50 (95% CI: 1.13, 1.98) when fish replaced any other protein-rich food, and 1.64 (95% CI: 1.14, 2.35) when fish replaced processed meat.
CONCLUSIONS:
Fish consumption is related to a higher probability of live birth following infertility treatment with ART.

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Omega-3 fatty acid addition during pregnancy.
Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M.
Cochrane Database Syst Rev. 2018 Nov 15;11:CD003402. doi: 10.1002/14651858.CD003402.pub3. [Epub ahead of print] Review.
PMID: 30480773
Abstract
BACKGROUND:
Higher intakes of foods containing omega-3 long-chain polyunsaturated fatty acids (LCPUFA), such as fish, during pregnancy have been associated with longer gestations and improved perinatal outcomes. This is an update of a review that was first published in 2006.
OBJECTIVES:
To assess the effects of omega-3 LCPUFA, as supplements or as dietary additions, during pregnancy on maternal, perinatal, and neonatal outcomes and longer-term outcomes for mother and child.
SEARCH METHODS:
For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (16 August 2018), and reference lists of retrieved studies.
SELECTION CRITERIA:
Randomised controlled trials (RCTs) comparing omega-3 fatty acids (as supplements or as foods, stand-alone interventions, or with a co-intervention) during pregnancy with placebo or no omega-3, and studies or study arms directly comparing omega-3 LCPUFA doses or types. Trials published in abstract form were eligible for inclusion.
DATA COLLECTION AND ANALYSIS:
Two review authors independently assessed study eligibility, extracted data, assessed risk of bias in trials and assessed quality of evidence for prespecified birth/infant, maternal, child/adult and health service outcomes using the GRADE approach.
MAIN RESULTS:
In this update, we included 70 RCTs (involving 19,927 women at low, mixed or high risk of poor pregnancy outcomes) which compared omega-3 LCPUFA interventions (supplements and food) compared with placebo or no omega-3. Overall study-level risk of bias was mixed, with selection and performance bias mostly at low risk, but there was high risk of attrition bias in some trials. Most trials were conducted in upper-middle or high-income countries; and nearly half the trials included women at increased/high risk for factors which might increase the risk of adverse maternal and birth outcomes.Preterm birth < 37 weeks (13.4% versus 11.9%; risk ratio (RR) 0.89, 95% confidence interval (CI) 0.81 to 0.97; 26 RCTs, 10,304 participants; high-quality evidence) and early preterm birth < 34 weeks (4.6% versus 2.7%; RR 0.58, 95% CI 0.44 to 0.77; 9 RCTs, 5204 participants; high-quality evidence) were both lower in women who received omega-3 LCPUFA compared with no omega-3. Prolonged gestation > 42 weeks was probably increased from 1.6% to 2.6% in women who received omega-3 LCPUFA compared with no omega-3 (RR 1.61 95% CI 1.11 to 2.33; 5141 participants; 6 RCTs; moderate-quality evidence).For infants, there was a possibly reduced risk of perinatal death (RR 0.75, 95% CI 0.54 to 1.03; 10 RCTs, 7416 participants; moderate-quality evidence: 62/3715 versus 83/3701 infants) and possibly fewer neonatal care admissions (RR 0.92, 95% CI 0.83 to 1.03; 9 RCTs, 6920 participants; moderate-quality evidence - 483/3475 infants versus 519/3445 infants). There was a reduced risk of low birthweight (LBW) babies (15.6% versus 14%; RR 0.90, 95% CI 0.82 to 0.99; 15 trials, 8449 participants; high-quality evidence); but a possible small increase in large-for-gestational age (LGA) babies (RR 1.15, 95% CI 0.97 to 1.36; 6 RCTs, 3722 participants; moderate-quality evidence, for omega-3 LCPUFA compared with no omega-3. Little or no difference in small-for-gestational age or intrauterine growth restriction (RR 1.01, 95% CI 0.90 to 1.13; 8 RCTs, 6907 participants; moderate-quality evidence) was seen.For the maternal outcomes, there is insufficient evidence to determine the effects of omega-3 on induction post-term (average RR 0.82, 95% CI 0.22 to 2.98; 3 trials, 2900 participants; low-quality evidence), maternal serious adverse events (RR 1.04, 95% CI 0.40 to 2.72; 2 trials, 2690 participants; low-quality evidence), maternal admission to intensive care (RR 0.56, 95% CI 0.12 to 2.63; 2 trials, 2458 participants; low-quality evidence), or postnatal depression (average RR 0.99, 95% CI 0.56 to 1.77; 2 trials, 2431 participants; low-quality evidence). Mean gestational length was greater in women who received omega-3 LCPUFA (mean difference (MD) 1.67 days, 95% CI 0.95 to 2.39; 41 trials, 12,517 participants; moderate-quality evidence), and pre-eclampsia may possibly be reduced with omega-3 LCPUFA (RR 0.84, 95% CI 0.69 to 1.01; 20 trials, 8306 participants; low-quality evidence).For the child/adult outcomes, very few differences between antenatal omega-3 LCPUFA supplementation and no omega-3 were observed in cognition, IQ, vision, other neurodevelopment and growth outcomes, language and behaviour (mostly low-quality to very low-quality evidence). The effect of omega-3 LCPUFA on body mass index at 19 years (MD 0, 95% CI -0.83 to 0.83; 1 trial, 243 participants; very low-quality evidence) was uncertain. No data were reported for development of diabetes in the children of study participants.
AUTHORS' CONCLUSIONS:
In the overall analysis, preterm birth < 37 weeks and early preterm birth < 34 weeks were reduced in women receiving omega-3 LCPUFA compared with no omega-3. There was a possibly reduced risk of perinatal death and of neonatal care admission, a reduced risk of LBW babies; and possibly a small increased risk of LGA babies with omega-3 LCPUFA.For our GRADE quality assessments, we assessed most of the important perinatal outcomes as high-quality (e.g. preterm birth) or moderate-quality evidence (e.g. perinatal death). For the other outcome domains (maternal, child/adult and health service outcomes) GRADE ratings ranged from moderate to very low, with over half rated as low. Reasons for downgrading across the domain were mostly due to design limitations and imprecision.Omega-3 LCPUFA supplementation during pregnancy is an effective strategy for reducing the incidence of preterm birth, although it probably increases the incidence of post-term pregnancies. More studies comparing omega-3 LCPUFA and placebo (to establish causality in relation to preterm birth) are not needed at this stage. A further 23 ongoing trials are still to report on over 5000 women, so no more RCTs are needed that compare omega-3 LCPUFA against placebo or no intervention. However, further follow-up of completed trials is needed to assess longer-term outcomes for mother and child, to improve understanding of metabolic, growth and neurodevelopment pathways in particular, and to establish if, and how, outcomes vary by different types of omega-3 LCPUFA, timing and doses; or by characteristics of women.

Sunspot data and human longevity.
Davis GE Jr, Lowell WE.
Data Brief. 2018 Nov 6;21:1579-1590. doi: 10.1016/j.dib.2018.10.168. eCollection 2018 Dec.
PMID: 30480071
Abstract
Solar energy at birth and human lifespan, Journal of Photochemistry & Photobiology B 186 (2018)59-68. This paper uses National Center for Health Statistics (NCHS) death data collected from 1979- 2013, inclusive, and average monthly solar intensity as measured by sunspot number collected from the National Oceanic and Atmospheric Administration (NOAA) from 1900-2013, inclusive.
KEYWORDS:
Epigenetics; Human lifespan; Multiple sclerosis; Solar energy; Sunspot number; Ultraviolet radiation
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Solar energy at birth and human lifespan.
Davis GE Jr, Lowell WE.
J Photochem Photobiol B. 2018 Sep;186:59-68. doi: 10.1016/j.jphotobiol.2018.07.006. Epub 2018 Jul 5.
PMID: 30015061
https://sci-hub.tw/10.1016/j.jphotobiol.2018.07.006
Abstract
PURPOSE:
The purpose of this paper is to examine the role of UVR at birth and its relationship to lifespan and determine whether there are significant differential effects on sex and race. We test if variation in UVR, as determined by solar cycles (long-term variation), is related to survival as measured by age at death.
METHODS:
The data used 78 million death records from the National Center for Health Statistics (NCHS) from 1979 to 2013 with accidents, suicides, and war casualties deleted resulted in ~63 million records. Records of persons ≤ 47 years old were also scrubbed because we could not show an effect on lifespan based upon the intensity of solar energy as reflected by sunspot number (SSN). This we hypothesize is due to the protective effect of the hormones associated with growth and reproduction. Also selected were persons afflicted with multiple sclerosis (MS).
RESULTS:
Males of all races born with a UVR intensity as estimated by sunspot number (SSN) ≤ 90 had an average lifespan of 74.4 years, for females of all races, 78.1 years; males born with >90 had an average lifespan of 66.3 years, for females of all races, 70.2 years, resulting in a lifespan decrease of 8.1 years for males and 8.5 years for females. For African-American males born ≤ 90 SSN, 70.8 years and for >90 SSN, 62.5 years, an 8.3-year decrease; similarly, for African-American females ≤ 90 SSN, 75.0, for >90 SSN, 65.4 years, a 9.6-year decrease. Higher solar energy at birth had an adverse effect on human lifespan. We also found that there were twice as many persons with MS born in >80-90 SSN as in the general population.
CONCLUSIONS:
There is a statistically significant inverse relationship between exposure to solar energy at birth and average human lifespan. Solar energy by some mechanism alters the epigenome at birth, but the effect of higher solar energy becomes apparent after the age of natural selection.
KEYWORDS:
Epigenetics; Human lifespan; Multiple sclerosis; Solar energy; Sunspot number; Ultraviolet radiation

Serum alkaline phosphatase and the risk of coronary heart disease, stroke and all-cause mortality: Tehran Lipid and Glucose Study.
Kabootari M, Raee MR, Akbarpour S, Asgari S, Azizi F, Hadaegh F.
BMJ Open. 2018 Nov 25;8(11):e023735. doi: 10.1136/bmjopen-2018-023735.
PMID: 30478120
https://bmjopen.bmj.com/content/bmjopen/8/11/e023735.full.pdf
Abstract
OBJECTIVES:
To investigate the association of alkaline phosphatase (ALP) levels with the risk of the composite end point of cardiovascular disease (CVD), and all-cause mortality as well as each of them separately.
DESIGN:
Prospective cohort study.
SETTING:
Within the framework of the Tehran Lipid and Glucose Study (TLGS) cohort, participants were followed from baseline examination (1999-2001) until March 2014.
PARTICIPANTS:
A total of 2578 participants, aged ≥30 years free of prevalent CVD at baseline examination.
PRIMARY OUTCOME:
The main outcome measures were composite end point of coronary heart disease (CHD), stroke, all-cause mortality and each per se.
RESULTS:
During a median follow-up of 11.3 years, 369, 68, 420, 170 and 495 participants experienced CHD, stroke, CVD, all-cause mortality and the composite outcome, respectively. In the multivariable Cox regression models, the adjusted HRs (95% CI) for mentioned events per one SD increase in ALP level after full adjustment were 1.11 (1.01 to 1.22), 1.20 (0.97 to 1.49, p=0.058), 1.10 (1.01 to 1.21), 1.16 (1.01 to 1.33) and 1.11 (1.02 to 1.21), respectively. Furthermore, participants with ALP levels in the highest tertile had significant adjusted HRs (95% CI) for stroke (1.88 (1.00 to 3.61)), CVD (1.30 (1.01 to 1.68)) and composite outcome (1.27 (1.00 to 1.61)). The cut-off value of ALP ≥199 IU/L for predicting composite outcome was derived using Youden's index, based on which this cut-off point was associated with significant risk of 80%, 26%, 43% and 26% for incident stroke, CVD, all-cause mortality and composite outcome. Additionally, no improvement was seen in the predictive ability of traditional risk factors models after adding ALP values, considering the levels of Akaike information criterion, C-index and Net Reclassification Index.
CONCLUSION:
Independent associations between ALP levels and the risks of CVD and mortality events were shown, despite the fact that adding the data of ALP to known risk factors did not improve the prediction of these events.
KEYWORDS:
alkaline phosphatase; all-cause mortality; cardiovascular disease; coronary heart disease; stroke

Vitamin A supplementation decreases disease activity index in patients with ulcerative colitis: A randomized controlled clinical trial.
Masnadi Shirazi K, Nikniaz Z, Masnadi Shirazi A, Rohani M.
Complement Ther Med. 2018 Dec;41:215-219. doi: 10.1016/j.ctim.2018.09.026. Epub 2018 Sep 28.
PMID: 30477842
Abstract
INTRODUCTION:
Considering the link between vitamin A deficiency and disease activity in ulcerative colitis (UC) and also the association between dietary intake of vitamin A and gastrointestinal symptoms in these patients, this study aimed to investigate the effect of vitamin A supplementation on disease activity in patients with UC.
METHOD:
In the present double-blind randomized controlled clinical trial, one hundred and fifty patients with Mayo score of 6-12 were randomly assigned to receive 25,000 IU/day vitamin A supplements or placebo for two months. The disease activity was calculated by the Mayo clinic score. Within groups and between groups comparisons were performed using paired sample t-test and one-way ANCOVA respectively. For measuring the treatment effect, the response ratio and number needed to treat (NNT) was calculated for the rate of clinical response and mucosal healing.
RESULTS:
One hundred and forty three patients completed the study. After two months of supplementation, significant decreases in Mayo clinic score (p < 0.001) and subscores (p < 0.001) was observed in the intervention group. There were significant differences between the two groups regarding Mayo clinic score and subscores after adjusting for age, sex, BMI, disease duration and baseline values (P < 0.05). Moreover, there were significant differences between two groups regarding clinical response ratio (P < 0.001) and mucosal healing ratio (P < 0.001). The NNT [95%CI] values for the clinical response was 3 [2-40] and for the mucosal healing was 5 [2.90-10.4].
CONCLUSION:
Although according to the results, daily dose of 25,000 IU vitamin A had positive clinical and endoscopic effects, considering the limitations, further studies with longer duration and larger sample size and considering dietary intake are needed to confirm these preliminary results.
KEYWORDS:
Disease activity index; Endoscopy; Mayo clinic score; Mucosal healing; Ulcerative colitis; Vitamin A

Dose-response relation between serum total cholesterol levels and overall cancer risk: evidence from 12 prospective studies involving 1,926,275 participants.
Wu B, Teng L, He D, Yu DD, Jiang F.
Int J Food Sci Nutr. 2018 Nov 27:1-10. doi: 10.1080/09637486.2018.1529147. [Epub ahead of print]
PMID: 30481081
Abstract
This study aimed to clarify the association between serum total cholesterol (TC) levels and overall cancer risk. Study-specific relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects model, and dose-response relation was also evaluated. Twelve prospective studies were identified with a total of 1,926,275 participants and 13,1676 cases. High levels of serum TC showed an inverse association with overall cancer risk (RR for the highest versus the lowest category: 0.87, 95% CI: 0.83 ∼ 0.90; I2 = 52.5%). A linear dose-response relation between serum TC levels and overall cancer risk was found (p = .004 for Wald test; I2 = 49.6%), and the pooled RR was 0.92 (95% CI: 0.89 ∼ 0.94) for 3 mmol/L, 0.86 (95% CI: 0.81 ∼ 0.90) for 5 mmol/L, 0.80 (95% CI: 0.74 ∼ 0.87) for 7 mmol/L. Our dose-response meta-analysis of 12 prospective studies indicated that higher serum TC levels were significantly associated with reduced cancer risk.
KEYWORDS:
Serum; cancer risk; dose-response; meta-analysis; total cholesterol

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MIND Diet Associated with Reduced Incidence and Delayed Progression of ParkinsonismA in Old Age.
Agarwal P, Wang Y, Buchman AS, Holland TM, Bennett DA, Morris MC.
J Nutr Health Aging. 2018;22(10):1211-1215. doi: 10.1007/s12603-018-1094-5.
PMID: 30498828
Abstract
BACKGROUND:
In old age, motor impairments including parkinsonian signs are common, but treatment is lacking for many older adults. In this study, we examined the association of a diet specifically developed to promote brain health, called MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay), to the incidence and progression of parkinsonism in older adults.
METHODS:
A total of 706 Memory and Aging Project participants aged 59 -97 years and without parkinsonism at baseline were assessed annually for the presence of four parkinsonian signs using a 26-item modified version of the United Parkinson's Disease Rating Scale. Incident parkinsonism was defined as the first occurrence over 4.6 years of follow-up of two or more parkinsonian signs. The progression of parkinsonism was assessed by change in a global parkinsonian score (range: 0-100). MIND, Mediterranean, and DASH diet pattern scores were computed based on a validated food frequency questionnaire including 144 food items. We employed Cox-Proportional Hazard models and linear mixed models, to examine the associations of baseline diet scores with incident parkinsonism and the annual rate of change in global parkinsonian score, respectively.
RESULTS:
In models adjusted for age, sex, smoking, total energy intake, BMI and depressive symptoms, higher MIND diet scores were associated with a decreased risk of parkinsonism [(HR=0.89, 95% CI 0.83-0.96)]; and a slower rate of parkinsonism progression [(β= -0.008; SE=0.0037; p=0.04)]. The Mediterranean diet was marginally associated with reduced parkinsonism progression (β= -0.002; SE=0.0014; p=0.06). The DASH diet, by contrast, was not associated with either outcome.
CONCLUSION:
The MIND diet created for brain health may be a associated with decreased risk and slower progression of parkinsonism in older adults.
KEYWORDS:
MIND diet; Parkinsonism; dietary pattern; longitudinal; motor decline

Health and sustainability outcomes of vegetarian dietary patterns: a revisit of the EPIC-Oxford and the Adventist Health Study-2 cohorts.
Segovia-Siapco G, Sabaté J.
Eur J Clin Nutr. 2018 Oct 2. doi: 10.1038/s41430-018-0310-z. [Epub ahead of print] Review.
PMID: 30487555
Abstract
Knowledge in the role of plant-based diets on health had been shaped in part by cohort studies on vegetarians. We revisited publications from two ongoing longitudinal studies comprising large proportions of vegetarians-the Adventist Health Study-2 (AHS-2) and the European Prospective Investigation into Cancer and Nutrition-Oxford (EPIC-Oxford)-to describe the food and nutrient intake, health effects, and environmental sustainability outcomes of the dietary patterns identified in these studies. The vegetarian diet groups in both cohorts have essentially no meat intake, lower intake of fish and coffee, and higher intakes of vegetables and fruits compared to their non-vegetarian counterparts. In the AHS-2 cohort, vegetarians have higher intake of whole grains, legumes, nuts, and seeds. Vegans in AHS-2 have 16% reduced risk while vegans, vegetarians, and fish-eaters in EPIC-Oxford have 11-19% lower risk for all cancers compared to non-vegetarians. Pesco-vegetarians in the AHS-2 cohort had significantly lower mortality risk from all causes and ischemic heart disease while EPIC-Oxford fish-eaters had significantly lower all-cancers mortality risk than their non-vegetarians counterparts. Morbidity risks and prevalence rates for other chronic diseases were differentially reported in the two cohorts but vegetarians have lower risk than non-vegetarians. Greenhouse gas emissions of equicaloric diets are 29% less in vegetarian diet in AHS-2 and 47-60% less for vegetarian/vegan diets in EPIC-Oxford than non-vegetarian/meat-eating diets. The beneficial health outcomes and reduced carbon footprints make the case for adoption of vegetarian diets to address global food supply and environmental sustainability.

Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review.
Li R, Yu K, Li C.
Asia Pac J Clin Nutr. 2018;27(6):1344-1356. doi: 10.6133/apjcn.201811_27(6).0022.
PMID: 30485934
Abstract
BACKGROUND AND OBJECTIVES:
To evaluate the associations of dietary factors and the risk of gout and hyperuricemia.
METHODS AND STUDY DESIGN:
PubMed and Embase databases were searched from inception to June 2017 for eligible studies. Nineteen prospective cohort or cross-sectional studies with adequate sample sizes are included, all involving red meat, seafoods, alcohol, fructose, dairy products, soy foods, high-purine vegetables and coffee.
RESULTS:
Meta-analysis revealed several dietary associations with gout risk: red meat: OR 1.29 (95% CI 1.16-1.44); seafoods: OR 1.31 (95% CI 1.01-1.68); alcohol: OR 2.58 (95% CI 1.81-3.66); fructose: OR 2.14 (95% CI 1.65- 2.78); dairy products: OR 0.56 (95% CI 0.44-0.70); soy foods: OR 0.85 (95% CI 0.76-0.96); high-purine vegetables: OR 0.86 (95% CI 0.75-0.98); coffee: OR 0.47 (95% CI 0.37-0.59).Dietary association with hyperuricemia risk (red meat: OR 1.24 (95% CI 1.04-1.48); seafoods: OR 1.47 (95% CI 1.16-1.86); alcohol: OR 2.06 (95% CI 1.60-2.67); fructose: OR 1.85 (95% CI 1.66-2.07); dairy products: OR 0.50 (95% CI 0.37-0.66); soy foods: OR 0.70 (95% CI 0.56-0.88); high-purine vegetables ingestion: OR 1.10 (95% CI 0.88-1.39), P=0.39; coffee:OR0.76 in men (95% CI 0.55-1.06), OR 1.58 in women (95% CI 1.16-2.16).
CONCLUSION:
The risk of hyperuricemia and gout is positively correlated with the intake of red meat, seafoods, alcohol or fructose, and negatively with dairy products or soy foods. High-purine vegetables showed no association with hyperuricemia, but negative association with gout. Coffee intake is negatively associated with gout risk, whereas it may be associated with increased hyperuricemia risk in women but decreased risk in men.

Selenium and sex steroid hormones in a US nationally representative sample of men: A role for the link between selenium and estradiol in prostate carcinogenesis?
Van Hemelrijck M, Sollie S, Nelson WG, Yager JD, Kanarek NF, Dobs A, Platz EA, Rohrmann S.
Cancer Epidemiol Biomarkers Prev. 2018 Nov 27. pii: cebp.0520.2018. doi: 10.1158/1055-9965.EPI-18-0520. [Epub ahead of print]
PMID: 30482876
http://sci-hub.tw/http://cebp.aacrjournals.org/content/early/2018/11/27/1055-9965.EPI-18-0520
Abstract
BACKGROUND:
Given the recent findings from pooled studies about a potential inverse association between selenium levels and prostate cancer risk, the current cross-sectional study aimed to investigate the association between serum selenium and serum concentrations of sex steroid hormones including estradiol in a nationally representative sample of US men to investigate one mechanism by which selenium may influence prostate cancer risk.
METHODS:
The study included 1,420 men aged 20 years or older who participated in the Third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994. We calculated age/race-ethnicity-adjusted and multivariable-adjusted geometric mean serum concentrations of total and estimated free testosterone and estradiol, androstanediol glucuronide (AAG), and sex hormone binding globulin (SHBG) and compared them across quartiles of serum selenium.
RESULTS:
Adjusting for age, race/ethnicity, smoking status, serum cotinine, household income, physical activity, alcohol consumption and percent body fat, mean total estradiol (e.g. Q1:38.00 pg/mL (95%CI:36.03-40.08) vs Q4:35.29 pg/mL (33.53-37.14); Ptrend=0.050)and free estradiol [e.g.Q1: 0.96 pg/mL (95%CI: 0.92-1.01) vs Q4: 0.90 (95%CI:0.85-0.95); Ptrend=0.065] concentrations decreased over quartiles of selenium. Stratification by smoking and alcohol consumption, showed that the latter observation was stronger for never smokers (Pinteraction=0.073) and those with limited alcohol intake (Pinteraction=0.017). No associations were observed for the other sex steroid hormones studied.
CONCLUSION:
Our findings suggests that a possible mechanism by which selenium may be protective for prostate cancer is related to estrogen.
IMPACT:
Further studies of longitudinal measurements of serum and toenail selenium in relation to serum measurements of sex steroid hormones are needed.

Consumption of individual saturated fatty acids and the risk of myocardial infarction in a UK and a Danish cohort.
Praagman J, Vissers LET, Mulligan AA, Laursen ASD, Beulens JWJ, van der Schouw YT, Wareham NJ, Hansen CP, Khaw KT, Jakobsen MU, Sluijs I.
Int J Cardiol. 2018 Oct 22. pii: S0167-5273(17)36973-5. doi: 10.1016/j.ijcard.2018.10.064. [Epub ahead of print]
PMID: 30482628
https://sci-hub.tw/https://linkinghub.elsevier.com/retrieve/pii/S0167527317369735
Abstract
BACKGROUND:
The effect of individual saturated fatty acids (SFAs) on serum cholesterol levels depends on their carbon-chain length. Whether the association with myocardial infarction (MI) also differs across individual SFAs is unclear. We examined the association between consumption of individual SFAs, differing in chain lengths ranging from 4 through 18 carbons, and risk of MI.
METHODS:
We used data from 22,050 and 53,375 participants from EPIC-Norfolk (UK) and EPIC-Denmark, respectively. Baseline SFA intakes were assessed through validated, country-specific food frequency questionnaires. Cox regression analysis was used to estimate associations between intakes of individual SFAs and MI risk, for each cohort separately.
RESULTS:
During median follow-up times of 18.8 years in EPIC-Norfolk and 13.6 years in Denmark, respectively, 1204 and 2260 MI events occurred. Mean (±SD) total SFA intake was 13.3 (±3.5) en% in EPIC-Norfolk, and 12.5 (±2.6) en% in EPIC-Denmark. After multivariable adjustment, intakes of C12:0 (lauric acid) and C14:0 (myristic acid) inversely associated with MI risk in EPIC-Denmark (HR upper versus lowest quintile: 0.80 (95%CI: 0.66, 0.96) for both SFAs). Intakes in the third and fourth quintiles of C4:0-C10:0 also associated with lower MI risk in EPIC-Denmark. Moreover, substitution of C16:0 (palmitic acid) and C18:0 (stearic acid) with plant proteins resulted in a reduction of MI risk in EPIC-Denmark (HR per 1 energy%: 0.86 (95%CI: 0.78, 0.95) and 0.87 (95%CI: 0.79, 0.96) respectively). No such associations were found in EPIC-Norfolk.
CONCLUSION:
The results from the present study suggest that the association between SFA and MI risk depends on the carbon chain-length of the SFA.

Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women's Health Across the Nation.
Wang D, Jackson EA, Karvonen-Gutierrez CA, Elliott MR, Harlow SD, Hood MM, Derby CA, Sternfeld B, Janssen I, Crawford SL, Huang MH, El Khoudary SR, Chae CU, Baylin A.
J Am Heart Assoc. 2018 Dec 4;7(23):e010405. doi: 10.1161/JAHA.118.010405.
PMID: 30482079
https://www.ahajournals.org/doi/pdf/10.1161/JAHA.118.010405
Abstract
Background Measures of subclinical atherosclerosis are predictors of future cardiovascular outcomes as well as of physical and cognitive functioning. The menopausal transition is associated with accelerated progression of atherosclerosis in women. The prospective association between a healthy lifestyle during the midlife and subclinical atherosclerosis is unclear. Methods and Results Self-reported data on smoking, diet, and physical activity from 1143 women in the Study of Women's Health Across the Nation were used to construct a 10-year average Healthy Lifestyle Score ( HLS ) during the midlife. Markers of subclinical atherosclerosis were measured 14 years after baseline and included common carotid artery intima-media thickness ( CCA - IMT ), adventitial diameter ( CCA - AD ), and carotid plaque. The associations of average HLS with CCA - IMT and CCA - AD were estimated using linear models; the association of average HLS with carotid plaque was estimated using cumulative logit models. Average HLS was associated with smaller CCA - IMT and CCA - AD in the fully adjusted models ( P=0.0031 and <0.001, respectively). Compared with participants in the lowest HLS level, those in the highest level had 0.024 mm smaller CCA - IMT (95% confidence interval: -0.048, 0.000), which equals 17% of the SD of CCA - IMT , and 0.16 mm smaller CCA - AD (95% confidence interval: -0.27, -0.04), which equals 24% of the SD of CCA - AD . Among the 3 components of the HLS , abstinence from smoking had the strongest association with subclinical atherosclerosis. Conclusions Healthy lifestyle during the menopausal transition is associated with less subclinical atherosclerosis, highlighting the growing recognition that the midlife is a critical window for cardiovascular prevention in women.
KEYWORDS:
atherosclerosis; cardiovascular disease; lifestyle; risk factors; women

Telomere length and telomerase activity in T cells are biomarkers of high-performing centenarians.
Tedone E, Huang E, O'Hara R, Batten K, Ludlow AT, Lai TP, Arosio B, Mari D, Wright WE, Shay JW.
Aging Cell. 2018 Nov 28:e12859. doi: 10.1111/acel.12859. [Epub ahead of print]
PMID: 30488553
Abstract
It is generally recognized that the function of the immune system declines with increased age and one of the major immune changes is impaired T-cell responses upon antigen presentation/stimulation. Some "high-performing" centenarians (100+ years old) are remarkably successful in escaping, or largely postponing, major age-related diseases. However, the majority of centenarians ("low-performing") have experienced these pathologies and are forced to reside in long-term nursing facilities. Previous studies have pooled all centenarians examining heterogeneous populations of resting/unstimulated peripheral blood mononuclear cells (PBMCs). T cells represent around 60% of PBMC and are in a quiescence state when unstimulated. However, upon stimulation, T cells rapidly divide and exhibit dramatic changes in gene expression. We have compared stimulated T-cell responses and identified a set of transcripts expressed in vitro that are dramatically different in high- vs. low-performing centenarians. We have also identified several other measurements that are different between high- and low-performing centenarians: (a) The amount of proliferation following in vitro stimulation is dramatically greater in high-performing centenarians compared to 67- to 83-year-old controls and low-performing centenarians; (b) telomere length is greater in the high-performing centenarians; and (c) telomerase activity following stimulation is greater in the high-performing centenarians. In addition, we have validated a number of genes whose expression is directly related to telomere length and these are potential fundamental biomarkers of aging that may influence the risk and progression of multiple aging conditions.
KEYWORDS:
centenarians; healthy aging; longevity; stimulated T cells; telomerase activity; telomeres

Omega-6 fats for the primary and secondary prevention of cardiovascular disease.
Hooper L, Al-Khudairy L, Abdelhamid AS, Rees K, Brainard JS, Brown TJ, Ajabnoor SM, O'Brien AT, Winstanley LE, Donaldson DH, Song F, Deane KH.
Cochrane Database Syst Rev. 2018 Nov 29;11:CD011094. doi: 10.1002/14651858.CD011094.pub4. [Epub ahead of print] Review.
PMID: 30488422
Abstract
BACKGROUND:
Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovascular disease (CVD) risk is debated.
OBJECTIVES:
To assess effects of increasing omega-6 fats (linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA)) on CVD and all-cause mortality.
SEARCH METHODS:
We searched CENTRAL, MEDLINE and Embase to May 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.
SELECTION CRITERIA:
We included randomised controlled trials (RCTs) comparing higher versus lower omega-6 fat intake in adults with or without CVD, assessing effects over at least 12 months. We included full texts, abstracts, trials registry entries and unpublished studies. Outcomes were all-cause mortality, CVD mortality, CVD events, risk factors (blood lipids, adiposity, blood pressure), and potential adverse events. We excluded trials where we could not separate omega-6 fat effects from those of other dietary, lifestyle or medication interventions.
DATA COLLECTION AND ANALYSIS:
Two authors independently screened titles/abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias of included trials. We wrote to authors of included studies. Meta-analyses used random-effects analysis, while sensitivity analyses used fixed-effects and limited analyses to trials at low summary risk of bias. We assessed GRADE quality of evidence for 'Summary of findings' tables.
MAIN RESULTS:
We included 19 RCTs in 6461 participants who were followed for one to eight years. Seven trials assessed the effects of supplemental GLA and 12 of LA, none DGLA or AA; the omega-6 fats usually displaced dietary saturated or monounsaturated fats. We assessed three RCTs as being at low summary risk of bias.Primary outcomes: we found low-quality evidence that increased intake of omega-6 fats may make little or no difference to all-cause mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.88 to 1.12, 740 deaths, 4506 randomised, 10 trials) or CVD events (RR 0.97, 95% CI 0.81 to 1.15, 1404 people experienced events of 4962 randomised, 7 trials). We are uncertain whether increasing omega-6 fats affects CVD mortality (RR 1.09, 95% CI 0.76 to 1.55, 472 deaths, 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997 randomised, 7 trials), major adverse cardiac and cerebrovascular events (RR 0.84, 95% CI 0.59 to 1.20, 817 events, 2879 participants, 2 trials) or stroke (RR 1.36, 95% CI 0.45 to 4.11, 54 events, 3730 participants, 4 trials), as we assessed the evidence as being of very low quality. We found no evidence of dose-response or duration effects for any primary outcome, but there was a suggestion of greater protection in participants with lower baseline omega-6 intake across outcomes.Additional key outcomes: we found increased intake of omega-6 fats may reduce myocardial infarction (MI) risk (RR 0.88, 95% CI 0.76 to 1.02, 609 events, 4606 participants, 7 trials, low-quality evidence). High-quality evidence suggests increasing omega-6 fats reduces total serum cholesterol a little in the long term (mean difference (MD) -0.33 mmol/L, 95% CI -0.50 to -0.16, I2 = 81%; heterogeneity partially explained by dose, 4280 participants, 10 trials). Increasing omega-6 fats probably has little or no effect on adiposity (body mass index (BMI) MD -0.20 kg/m2, 95% CI -0.56 to 0.16, 371 participants, 1 trial, moderate-quality evidence). It may make little or no difference to serum triglycerides (MD -0.01 mmol/L, 95% CI -0.23 to 0.21, 834 participants, 5 trials), HDL (MD -0.01 mmol/L, 95% CI -0.03 to 0.02, 1995 participants, 4 trials) or low-density lipoprotein (MD -0.04 mmol/L, 95% CI -0.21 to 0.14, 244 participants, 2 trials, low-quality evidence).
AUTHORS' CONCLUSIONS:
This is the most extensive systematic assessment of effects of omega-6 fats on cardiovascular health, mortality, lipids and adiposity to date, using previously unpublished data. We found no evidence that increasing omega-6 fats reduces cardiovascular outcomes other than MI, where 53 people may need to increase omega-6 fat intake to prevent 1 person from experiencing MI. Although benefits of omega-6 fats remain to be proven, increasing omega-6 fats may be of benefit in people at high risk of MI. Increased omega-6 fats reduce serum total cholesterol but not other blood fat fractions or adiposity.

Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease.
Abdelhamid AS, Martin N, Bridges C, Brainard JS, Wang X, Brown TJ, Hanson S, Jimoh OF, Ajabnoor SM, Deane KH, Song F, Hooper L.
Cochrane Database Syst Rev. 2018 Nov 27;11:CD012345. doi: 10.1002/14651858.CD012345.pub3. [Epub ahead of print] Review.
PMID: 30484282
Abstract
BACKGROUND:
Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests that increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear.
OBJECTIVES:
To assess effects of increasing total PUFA intake on cardiovascular disease and all-cause mortality, lipids and adiposity in adults.
SEARCH METHODS:
We searched CENTRAL, MEDLINE and Embase to April 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.
SELECTION CRITERIA:
We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults with or without cardiovascular disease that assessed effects over 12 months or longer. We included full texts, abstracts, trials registry entries and unpublished data. Outcomes were all-cause mortality, cardiovascular disease mortality and events, risk factors (blood lipids, adiposity, blood pressure), and adverse events. We excluded trials where we could not separate effects of PUFA intake from other dietary, lifestyle or medication interventions.
DATA COLLECTION AND ANALYSIS:
Two review authors independently screened titles and abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias. We wrote to authors of included trials for further data. Meta-analyses used random-effects analysis, sensitivity analyses included fixed-effects and limiting to low summary risk of bias. We assessed GRADE quality of evidence.
MAIN RESULTS:
We included 49 RCTs randomising 24,272 participants, with duration of one to eight years. Eleven included trials were at low summary risk of bias, 33 recruited participants without cardiovascular disease. Baseline PUFA intake was unclear in most trials, but 3.9% to 8% of total energy intake where reported. Most trials gave supplemental capsules, but eight gave dietary advice, eight gave supplemental foods such as nuts or margarine, and three used a combination of methods to increase PUFA.Increasing PUFA intake probably has little or no effect on all-cause mortality (risk 7.8% vs 7.6%, risk ratio (RR) 0.98, 95% confidence interval (CI) 0.89 to 1.07, 19,290 participants in 24 trials), but probably slightly reduces risk of coronary heart disease events from 14.2% to 12.3% (RR 0.87, 95% CI 0.72 to 1.06, 15 trials, 10,076 participants) and cardiovascular disease events from 14.6% to 13.0% (RR 0.89, 95% CI 0.79 to 1.01, 17,799 participants in 21 trials), all moderate-quality evidence. Increasing PUFA may slightly reduce risk of coronary heart disease death (6.6% to 6.1%, RR 0.91, 95% CI 0.78 to 1.06, 9 trials, 8810 participants) andstroke (1.2% to 1.1%, RR 0.91, 95% CI 0.58 to 1.44, 11 trials, 14,742 participants, though confidence intervals include important harms), but has little or no effect on cardiovascular mortality (RR 1.02, 95% CI 0.82 to 1.26, 16 trials, 15,107 participants) all low-quality evidence. Effects of increasing PUFA on major adverse cardiac and cerebrovascular events and atrial fibrillation are unclear as evidence is of very low quality.Increasing PUFA intake probably slightly decreases triglycerides (by 15%, MD -0.12 mmol/L, 95% CI -0.20 to -0.04, 20 trials, 3905 participants), but has little or no effect on total cholesterol (mean difference (MD) -0.12 mmol/L, 95% CI -0.23 to -0.02, 26 trials, 8072 participants), high-density lipoprotein (HDL) (MD -0.01 mmol/L, 95% CI -0.02 to 0.01, 18 trials, 4674 participants) or low-density lipoprotein (LDL) (MD -0.01 mmol/L, 95% CI -0.09 to 0.06, 15 trials, 3362 participants). Increasing PUFA probably has little or no effect on adiposity (body weight MD 0.76 kg, 95% CI 0.34 to 1.19, 12 trials, 7100 participants).Effects of increasing PUFA on serious adverse events such as pulmonary embolism and bleeding are unclear as the evidence is of very low quality.
AUTHORS' CONCLUSIONS:
This is the most extensive systematic review of RCTs conducted to date to assess effects of increasing PUFA on cardiovascular disease, mortality, lipids or adiposity. Increasing PUFA intake probably slightly reduces risk of coronary heart disease and cardiovascular disease events, may slightly reduce risk of coronary heart disease mortality and stroke (though not ruling out harms), but has little or no effect on all-cause or cardiovascular disease mortality. The mechanism may be via TG reduction.

Mannose impairs tumour growth and enhances chemotherapy.
Gonzalez PS, O'Prey J, Cardaci S, Barthet VJA, Sakamaki JI, Beaumatin F, Roseweir A, Gay DM, Mackay G, Malviya G, Kania E, Ritchie S, Baudot AD, Zunino B, Mrowinska A, Nixon C, Ennis D, Hoyle A, Millan D, McNeish IA, Sansom OJ, Edwards J, Ryan KM.
Nature. 2018 Nov;563(7733):719-723. doi: 10.1038/s41586-018-0729-3. Epub 2018 Nov 21.
PMID: 30464341
https://sci-hub.tw/10.1038/s41586-018-0729-3
Abstract
It is now well established that tumours undergo changes in cellular metabolism1. As this can reveal tumour cell vulnerabilities and because many tumours exhibit enhanced glucose uptake2, we have been interested in how tumour cells respond to different forms of sugar. Here we report that the monosaccharide mannose causes growth retardation in several tumour types in vitro, and enhances cell death in response to major forms of chemotherapy. We then show that these effects also occur in vivo in mice following the oral administration of mannose, without significantly affecting the weight and health of the animals. Mechanistically, mannose is taken up by the same transporter(s) as glucose3 but accumulates as mannose-6-phosphate in cells, and this impairs the further metabolism of glucose in glycolysis, the tricarboxylic acid cycle, the pentose phosphate pathway and glycan synthesis. As a result, the administration of mannose in combination with conventional chemotherapy affects levels of anti-apoptotic proteins of the Bcl-2 family, leading to sensitization to cell death. Finally we show that susceptibility to mannose is dependent on the levels of phosphomannose isomerase (PMI). Cells with low levels of PMI are sensitive to mannose, whereas cells with high levels are resistant, but can be made sensitive by RNA-interference-mediated depletion of the enzyme. In addition, we use tissue microarrays to show that PMI levels also vary greatly between different patients and different tumour types, indicating that PMI levels could be used as a biomarker to direct the successful administration of mannose. We consider that the administration of mannose could be a simple, safe and selective therapy in the treatment of cancer, and could be applicable to multiple tumour types.

Optimum cutoff values of anthropometric indices of obesity for predicting hypertension: more than one decades of follow-up in an Iranian population.
Ramezankhani A, Ehteshami-Afshar S, Hasheminia M, Hajebrahimi MA, Azizi F, Hadaegh F.
J Hum Hypertens. 2018 Aug 6. doi: 10.1038/s41371-018-0093-7. [Epub ahead of print]
PMID: 30082689
Abstract
We determined cutoff points of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), for predicting hypertension in an Iranian population. Study sample included 6359 (3678 female) participants aged ≥20 and <60 years of a prospective cohort. The sex stratified multivariate hazard ratios (HRs) for all indices were estimated using Cox regression in two age groups (20-39 and 40-59 years). Receiver operating characteristic (ROC) was used to evaluate the predictive ability and determine the optimal cut-off values of the indices. In both genders and two age groups, the confounders adjusted HRs were significant for general and central obesity measures indices. AUCs of the indices were similar in men; however, among women 40-59 years, WC and WHtR had significantly higher AUC compared to BMI. Generally, the optimal cut-off values were higher in the 40-59 year age group. Optimal BMI, WC and WHR and WHtR cut-off values were 24.15 kg/m2, 90.5 cm, 0.90 and 0.49 among men, aged 20-39 years; the corresponding values were 28.41 kg/m2, 86.5 cm, 0.96 and 0.50 in men aged 40-59 years, respectively. In women, the aforementioned values were 26.38 kg/m2, 83.5 cm, 0.79 and 0.51 in the age group of 20-39 years, and 29.57 kg/m2, 90.5 cm, 0.88 and 0.59 in the 40-59 year age group, respectively. Our results suggest that gender and age differences in the association between anthropometric indices and hypertension should be considered.

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Your meals are speeding up climate change, but there's a way to eat sustainably
5 tips for trimming your culinary carbon footprint that don't involve going vegan
Emily Chung · CBC News · Posted: Dec 04, 2018
https://www.cbc.ca/news/technology/food-climate-change-carbon-footprint-1.4930062

Optimal protein intake during pregnancy for reducing the risk of fetal growth restriction: the Japan Environment and Children's Study.
Morisaki N, Nagata C, Yasuo S, Morokuma S, Kato K, Sanefuji M, Shibata E, Tsuji M, Senju A, Kawamoto T, Ohga S, Kusuhara K; Japan Environment and Children’s Study Group.
Br J Nutr. 2018 Dec;120(12):1432-1440. doi: 10.1017/S000711451800291X. Epub 2018 Nov 5.
PMID: 30394228
Abstract
Clinical trials show that protein supplement increases infant size in malnourished populations; however, epidemiological studies in high-income countries have reported mixed results. Although these findings suggest a non-linear relationship between maternal macronutrient intake and fetal growth, this relationship has not been closely examined. We assessed the association between maternal protein intake and fetal growth among 91 637 Japanese women with singletons in a nation-wide cohort study using validated FFQ. The respondents answered the FFQ twice, once during early pregnancy (FFQ1; 16·3 (sd 6·0) weeks), and second during mid-pregnancy (FFQ2, 28·1 (sd 4·1) weeks). Daily energy intake and percentage energy from protein, fats and carbohydrates were 7477 (sd 2577) kJ and 13·5 (sd 2·0), 29·5 (sd 6·5) and 55·3 (sd 7·8) %, respectively, for FFQ1, and 7184 (sd 2506) kJ and 13·6 (sd 2·1), 29·8 (sd 6·6) and 55·3 (sd 7·9) %, respectively, for FFQ2. The average birth weight was 3028 (sd 406) g, and 6350 infants (6·9 %) were small for gestational age (SGA). In both phases of the survey, birth weight was highest and the risk of SGA was lowest when the percentage energy from protein was 12 %, regardless of whether isoenergetic replacement was with fat or carbohydrates. Furthermore, when protein density in the maternal diet was held constant, birth weight was highest when 25 % of energy intake came from fat and 61 % came from carbohydrates during early pregnancy. We found maternal protein intake to have an inverse U-curve relationship with fetal growth. Our results strongly suggest that the effect of protein on birth weight is non-linear, and that a balanced diet fulfilling the minimum requirement for all macronutrients was ideal for avoiding fetal growth restriction.
KEYWORDS:
JECS Japan Environment and Children’s Study; SGA small for gestational age; Fetal growth; Macronutrients; Maternal diet; Protein; Small-for-gestational age

Effect of dietary interventions in mild cognitive impairment: a systematic review.
McGrattan AM, McEvoy CT, McGuinness B, McKinley MC, Woodside JV.
Br J Nutr. 2018 Dec;120(12):1388-1405. doi: 10.1017/S0007114518002945. Epub 2018 Nov 9.
PMID: 30409231
Abstract
Diet has been investigated in relation to its ability to promote cognitive function. However, evidence is currently limited and has rarely been systematically reviewed, particularly in a mild cognitive impairment (MCI) population. This review examined the effect of diet on cognitive outcomes in MCI patients. A total of five databases were searched to find randomised controlled trial (RCT) studies, with diet as the main focus, in MCI participants. The primary outcome was incident dementia and/or Alzheimer's disease (AD) and secondary outcomes included cognitive function across different domains using validated neuropsychological tests. Sixteen studies met the inclusion criteria. There was a high degree of heterogeneity relating to the nature of the dietary intervention and cognitive outcomes measured, thus making study comparisons difficult. Supplementation with vitamin E (one study, n 516), ginkgo biloba (one study, n 482) or Fortasyn Connect (one study, n 311) had no significant effect on progression from MCI to dementia and/or AD. For cognitive function, the findings showed some improvements in performance, particularly in memory, with the most consistent results shown by B vitamins, including folic acid (one study, n 266), folic acid alone (one study, n 180), DHA and EPA (two studies, n 36 and n 86), DHA (one study, n 240) and flavonol supplementation (one study, n 90). The findings indicate that dietary factors may have a potential benefit for cognitive function in MCI patients. Further well-designed trials are needed, with standardised and robust measures of cognition to investigate the influence of diet on cognitive status.
KEYWORDS:
AD Alzheimer’s disease; GI glycaemic index; HF high flavonol; HR hazard ratio; LF low flavonol; MCI mild cognitive impairment; MMSE Mini Mental State Examination; RCT randomised controlled trial; Diet; Interventions; Lifestyle; Mild cognitive impairment; Systematic reviews

Involvement of calcium-sensing receptor activation in the alleviation of intestinal inflammation in a piglet model by dietary aromatic amino acid supplementation.
Liu H, Tan B, Huang B, Li J, Wang J, Liao P, Guan G, Ji P, Yin Y.
Br J Nutr. 2018 Dec;120(12):1321-1331. doi: 10.1017/S0007114518002891. Epub 2018 Oct 30.
PMID: 30375295
https://sci-hub.tw/10.1017/S0007114518002891
Abstract
Ca2+-sensing receptor (CaSR) represents a potential therapeutic target for inflammatory bowel diseases and strongly prefers aromatic amino acid ligands. We investigated the regulatory effects of dietary supplementation with aromatic amino acids - tryptophan, phenylalanine and tyrosine (TPT) - on the CaSR signalling pathway and intestinal inflammatory response. The in vivo study was conducted with weanling piglets using a 2 × 2 factorial arrangement in a randomised complete block design. Piglets were fed a basal diet or a basal diet supplemented with TPT and with or without inflammatory challenge. The in vitro study was performed in porcine intestinal epithelial cell line to investigate the effects of TPT on inflammatory response using NPS-2143 to inhibit CaSR. Dietary supplementation of TPT alleviated histopathological injury and decreased myeloperoxidase activity in intestine challenged with lipopolysaccharide. Dietary supplementation of TPT decreased serum concentration of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, IL-12, granulocyte-macrophage colony-stimulating factor, TNF-α), as well as the mRNA abundances of pro-inflammatory cytokines in intestine but enhanced anti-inflammatory cytokines IL-4 and transforming growth factor-β mRNA levels compared with pigs fed control diet and infected by lipopolysaccharide. Supplementation of TPT increased CaSR and phospholipase Cβ2 protein levels, but decreased inhibitor of NF-κB kinase α/β and inhibitor of NF-κB (IκB) protein levels in the lipopolysaccharide-challenged piglets. When the CaSR signalling pathway was blocked by NPS-2143, supplementation of TPT decreased the CaSR protein level, but enhanced phosphorylated NF-κB and IκB levels in IPEC-J2 cells. To conclude, supplementation of aromatic amino acids alleviated intestinal inflammation as mediated through the CaSR signalling pathway.
KEYWORDS:
BW body weight; CCL2 CC chemokine ligand 2; CaSR calcium-sensing receptor; GM-CSF granulocyte–macrophage colony-stimulating factor; IKK inhibitor of NF-κB kinase; IκB inhibitor of NF-κB; LPS lipopolysaccharide; MCP monocyte chemoattractant protein; MPO myeloperoxidase; PLC phospholipase C; Phe phenylalanine; TGF transforming growth factor; TPT tryptophan phenylalanine and tyrosine; Trp tryptophan; Tyr tyrosine; p-NF-κB phosphorylated NF-κB; Aromatic amino acids; Calcium-sensing receptor; Inflammatory response; Piglet model

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Reversibility of irreversible aging.
Galkin F, Zhang B, Dmitriev SE, Gladyshev VN.
Ageing Res Rev. 2018 Dec 1. pii: S1568-1637(18)30254-X. doi: 10.1016/j.arr.2018.11.008. [Epub ahead of print] Review.
PMID: 30513346
https://sci-hub.tw/10.1016/j.arr.2018.11.008
Abstract
Most multicellular organisms are known to age, due to accumulation of damage and other deleterious changes over time. These changes are often irreversible as organisms, humans included, evolved fully differentiated, irreplaceable cells (e.g. neurons) and structures (e.g. skeleton). Hence, deterioration or loss of at least some cells and structures should lead to inevitable aging of these organisms. Yet, some cells may escape this fate: adult somatic cells may be converted to partially reprogrammed cells or induced pluripotent stem cells (iPSCs). By their nature, iPSCs are the cells representing the early stages of life, indicating a possibility of reversing the age of cells within the organism. Reprogramming strategies may be accomplished both in vitro and in vivo, offering opportunities for rejuvenation in the context of whole organisms. Similarly, older organs may be replaced with the younger ones prepared ex vivo, or grown within other organisms or even other species. How could the irreversibility of aging of some parts of the organism be reconciled with the putative reversal of aging in the other parts of the same organism? Resolution of this question holds promise for dramatically extending lifespan, which is currently not possible with traditional genetic, dietary and pharmacological approaches. Critical issues in this challenge are the nature of aging, relationship between aging of an organism and aging of its parts, relationship between cell dedifferentiation and rejuvenation, and increased risk of cancer that goes hand in hand with rejuvenation approaches.

Clinical evidence on the effects of saffron (Crocus sativus L.) on cardiovascular risk factors: A systematic review meta-analysis.
Pourmasoumi M, Hadi A, Najafgholizadeh A, Kafeshani M, Sahebkar A.
Pharmacol Res. 2018 Nov 28;139:348-359. doi: 10.1016/j.phrs.2018.11.038. [Epub ahead of print] Review.
PMID: 30502528
Abstract
Cardiovascular disease is a one of most common causes of mortality around the world. This meta-analysis aims to summarize and conclude the clinical evidence regarding the use of saffron and its constituents, in particular crocin, on cardiovascular risk factors. A systematic review was conducted with PubMed, Scopus, Web of Science, Cochrane library and Google Scholar up to 24 May 2018. Randomized controlled trials (RCTs) that assessed the clinical effects of saffron and/or its constituents on blood lipid profile, glycemic parameters, blood pressure and anthropometric indices in human subjects were included. Eleven publication from ten studies comprising 622 participants included in quantitative analysis. Pooling of results showed significant effect of saffron on diastolic blood pressure (-1.24 mmHg; 95% CI: -1.51 to -0.96; I2 = 0%), body weight (-1.29 kg; 95% CI: -2.14 to -0.44; I2 = 70%) and waist circumstance (-1.68 cm; 95% CI: -3.31 to -0.04; I2 = 51%). When subgroup analysis was performed based on quality of studies, a significant reduction in fasting plasma glucose levels was observed in subgroup with high quality studies (-10.14 mg/dl; 95% CI: -13.80 to -6.48; I2 = 0%). Meta-analysis did not reveal any significant change in lipid profile, fasting insulin, systolic blood pressure and body mass index following saffron consumption. Present meta-analysis suggests that saffron might be beneficial in several outcomes related with cardiovascular disease. However, further RCTs with long term intervention with different dose of administration are needed.
KEYWORDS:
Blood pressure; Body mass index; Fasting plasma glucose; Lipid profile; Meta-analysis; Saffron

Dietary intervention with a specific micronutrient combination for the treatment of patients with cardiac arrhythmias: the impact on insulin resistance and left ventricular function.
Parsi E, Bitterlich N, Winkelmann A, Rösler D, Metzner C.
BMC Cardiovasc Disord. 2018 Dec 3;18(1):220. doi: 10.1186/s12872-018-0954-6.
PMID: 30509185
https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-018-0954-6
Abstract
BACKGROUND:
Cardiac arrhythmias (CA) are very common and may occur with or without heart disease. Causes of these disturbances can be components of the metabolic syndrome (MetS) or deficits of micronutrients especially magnesium, potassium, B vitamins and coenzyme Q10. Both causes may also influence each other. Insulin resistance (IR) is a risk factor for diastolic dysfunction. One exploratory outcome of the present pilot study was to assess the impact of a dietary intervention with specific micronutrients on the lowering of IR levels in patients with CA with the goal to improve the left ventricular (LV) function.
METHODS:
This was a post hoc analysis of the randomized double blind, placebo-controlled pilot study in patients with CA (VPBs, SVPBs, SV tachycardia), which were recruited using data from patients who were 18-75 years of age in an Outpatient Practice of Cardiology. These arrhythmias were assessed by Holter ECG and LV function by standard echocardiography. Glucose metabolism was measured by fasting glucose, fasting insulin level and the Homeostasis Model Assessment of IR (HOMA-IR) at baseline and after 6 weeks of dietary supplementation.
RESULTS:
A total of 54 randomized patients with CA received either a specific micronutrient combination or placebo. Dietary intervention led to a significant decrease in fasting insulin ≥58 pmol/l (p = 0.020), and HOMA-IR (p = 0.053) in the verum group after 6 weeks. At the same time, parameters of LV diastolic function were improved after intervention in the verum group: significant reduction of LV mass index (p = 0.003), and in tendency both a decrease of interventricular septal thickness (p = 0.053) as well as an increase of E/A ratio (p = 0.051). On the other hand, the premature beats (PBs) were unchanged under verum.
CONCLUSIONS:
In this pilot study, dietary intervention with specific micronutrient combination as add-on to concomitant cardiovascular drug treatment seems to improve cardio metabolic health in patients with CA. Further studies are required.
STUDY REGISTRATION:
The study was approved by the Freiburg Ethics Commission International and was retrospectively registered with the U.S. National Institutes of Health Clinical Trials gov ID NCT 02652338 on 16 December 2015.
KEYWORDS:
Diastolic LV function; Dietary intervention; Glucose metabolism; LVMI; Premature beats

Postprandial energy expenditure of protein is affected by its phosphorus content.
Abdouni L, Olabi A, Obeid O.
J Therm Biol. 2018 Dec;78:214-218. doi: 10.1016/j.jtherbio.2018.10.013. Epub 2018 Oct 19.
PMID: 30509638
Abstract
Postprandial energy expenditure (PEE) is largely dependent on ATP production, which is may be affected by phosphorus (P) availability. Proteins are known to have high levels of P and induce high levels of PEE. This study aimed at assessing the effect of P in PEE of normal and high protein meals. A single-blind randomized crossover study was conducted with two groups of 12 healthy lean male subjects who received iso-caloric (554 Kcal) meals. Group1: normal protein (NPr) meal with or without P (500 mg) and group 2: high protein (HPr) meal with or without P (500 mg), on two visits separated by a minimum of 1-week washout period. Energy expenditure and substrate oxidation were measured at baseline and every 30 min for 4 h after meal ingestion using a ventilated hood for indirect calorimetry. NPr and HPr meals had similar postprandial energy expenditure and this was significantly increased (P = 0.005) by P ingestion. Our work shows that PEE of protein meal is highly affected by P content of the meal.
KEYWORDS:
High protein; Normal protein; Phosphorus; Postprandial energy expenditure

Lowering effects of n-3 fatty acid supplements on blood pressure by reducing plasma angiotensin II in Inner Mongolia hypertensive patients: A double-blind randomized controlled trial。.
Yang B, Shi L, Wang AM, Shi MQ, Li ZH, Zhao F, Guo XJ, Li D.
J Agric Food Chem. 2018 Dec 4. doi: 10.1021/acs.jafc.8b05463. [Epub ahead of print]
PMID: 30511840
Abstract
Whether n-3 fatty acid (FA) has hypotensive actions among Chinese adults remains inconclusive. Hypertensive patients from Inner Mongolia, China (n=126) were recruited to a double-blind, randomized controlled trial. We investigated the effects of n-3 FA supplements on blood pressure (BP, mm Hg), plasma concentrations of angiotensin II (Ang II, pg/mL) and nitric oxygen (NO, µmol/L), using fish oil (n=41, 4 capsules/day, equivalent to 2 grams of eicosapentaenoic acid plus docosahexaenoic acid) and flaxseed oil (n=42, 4 capsules/day, equivalent to 2.5 grams of α-linolenic acid). Comparing to the control group (corn oil, n=43), the mean systolic BP (-4.52±9.28 vs. -1.51±9.23, P=0.040) and the plasma Ang II levels (-12.68±10.87 vs. -4.93±9.08, P=0.023) were significantly lowered in fish oil group, whereas diastolic BP (P=0.285) and plasma NO levels (P=0.220) were not. Such findings suggest that marine-based n-3 FA has a hypotensive efficacy in Chinese hypertensive patients possibly through inhibiting Ang II-dependent vasoconstrictions.

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Meal frequency and vegetable intake does not predict the development of frailty in older adults.
Johannesson J, Rothenberg E, Gustafsson S, Slinde F.
Nutr Health. 2018 Dec 5:260106018815224. doi: 10.1177/0260106018815224. [Epub ahead of print]
PMID: 30514172
Abstract
BACKGROUND::
Frailty is considered highly prevalent among the aging population. Fruit and vegetable intake is associated with positive health outcomes across the life-span; however, the relationship with health benefits among older adults has received little attention.
AIM::
The aim was to examine if a relationship exists between meal frequency or frequency of vegetable intake and the development of frailty in a population of older adults.
METHODS::
A total of 371 individuals, 80 years or older, from the study 'Elderly Persons in the Risk Zone' were included. Data was collected in the participants' home by face-to-face interviews up to 24 months after the intervention. Baseline data were calculated using Chi2-test; statistical significance was accepted at the 5% level. Binary logistic regression was used for the relationship between meal frequency or vegetable intake and frailty.
RESULTS::
Mean meal frequency was 4.2 ± 0.9 meals per day; women seem to have a somewhat higher meal frequency than men (p=0.02); 57% of the participants had vegetables with at least one meal per day. No significant relationship was found between meal frequency or vegetable intake and frailty at 12 or 24 months follow-ups.
CONCLUSIONS::
Among this group of older adults (80+), meal frequency was slightly higher among women than men, and just over half of the participants had vegetables with at least one meal a day. The risk of developing frailty was not associated with meal frequency or vegetable intake. The questions in this study were meant as indicators for healthy food habits.
KEYWORDS:
Aged 80 and older; community dwelling; frailty; meal frequency; vegetable intake

'I don't want to get old': Meet the 91-year-old who backflips off the high diving board
Dubbed 'World's Most Extreme Grandpa' in viral video, John Carter of Trail, B.C., loves staying active
Roshini Nair · CBC News · Posted: Dec 04, 2018
https://www.cbc.ca/news/canada/british-columbia/extreme-grandpa-backflips-diving-board-1.4932000
>>>>>>>>>>>>>>>>>>
https://www.youtube.com/watch?v=CEySick9_Rw

Plant-Based Diets: Considerations for Environmental Impact, Protein Quality, and Exercise Performance.
Lynch H, Johnston C, Wharton C.
Nutrients. 2018 Dec 1;10(12). pii: E1841. doi: 10.3390/nu10121841. Review.
PMID: 30513704
https://www.mdpi.com/2072-6643/10/12/1841/htm
Abstract
Plant-based diets provide well-established physical and environmental health benefits. These benefits stem in part from the degree of restriction of animal-derived foods. Historically, meat and other animal-derived proteins have been viewed as an integral component of athletes' diets, leading some to question the adequacy of vegetarian or vegan diets for supporting athletic performance. The purpose of this review is to examine the impact of plant-based diets on human physical health, environmental sustainability, and exercise performance capacity. Based on currently available literature, it is unlikely that plant-based diets provide advantages, but do not suffer from disadvantages, compared to omnivorous diets for strength, anaerobic, or aerobic exercise performance. However, plant-based diets typically reduce the risk of developing numerous chronic diseases over the lifespan and require fewer natural resources for production compared to meat-containing diets. As such, plant-based diets appear to be viable options for adequately supporting athletic performance while concurrently contributing to overall physical and environmental health. Given the sparse literature comparing omnivore, vegetarian, and vegan athletes, particularly at the elite level, further research is warranted to ascertain differences that might appear at the highest levels of training and athletic performance.
KEYWORDS:
athlete; diet; exercise; health; nutrition; plant-based; protein; sustainability; vegan; vegetarian

Plant-based diet and adiposity over time in a middle-aged and elderly population: the Rotterdam Study.
Chen Z, Schoufour JD, Rivadeneira F, Lamballais S, Ikram MA, Franco OH, Voortman T.
Epidemiology. 2018 Nov 30. doi: 10.1097/EDE.0000000000000961. [Epub ahead of print]
PMID: 30507650
Abstract
BACKGROUND:
We aimed to explore whether adhering to a more plant-based diet, beyond strict vegan or vegetarian diets, may help prevent adiposity in a middle-aged and elderly population.
METHODS:
We included 9633 participants from the Rotterdam Study, a prospective cohort in the Netherlands. Dietary data were collected using food-frequency questionnaires at baseline of three sub-cohorts of the Rotterdam Study (1989-93, 2000-01, 2006-08). We created a plant-based diet index by giving plant-based foods positive scores and animal-based foods reverse scores. A higher score on the index reflected an overall more plant-based and less animal-based diet. Data on anthropometrics and body composition (using dual energy X-ray absorptiometry) were collected every 3 to 5 years from 1989-2016. We used multivariable linear mixed models to analyze the associations.
RESULTS:
In the 9633 participants, baseline plant-based diet score ranged from 21.0 to 73.0 with a mean ± SD of 49.0 ± 7.0. In multivariable-adjusted analyses, higher adherence to a plant-based diet was associated with lower BMI, waist circumference, fat mass index, and body fat percentage across a median follow-up period of 7.1 years (per 10 points higher score, BMI: β= -0.70 kg/m, (95% CI -0.81, -0.59); waist circumference: -2.0 cm (-2.3, -1.7); fat mass index: -0.66 kg/m (-0.80, -0.52); body fat percentage: -1.1 points (-1.3, -0.84)).
CONCLUSIONS:
In this population-based cohort of middle-aged and elderly participants, a higher adherence to a more plant-based, less animal-based diet was associated with less adiposity over time, irrespective of general healthfulness of the specific plant- and animal-based foods.

Serum gut microbe-dependent trimethylamine N-oxide improves the prediction of future cardiovascular disease in a community-based general population.
Zheng L, Zheng J, Xie Y, Li Z, Guo X, Sun G, Sun Z, Xing F, Sun Y.
Atherosclerosis. 2018 Nov 8;280:126-131. doi: 10.1016/j.atherosclerosis.2018.11.010. [Epub ahead of print]
PMID: 30508691
https://sci-hub.tw/10.1016/j.atherosclerosis.2018.11.010
Abstract
BACKGROUND AND AIMS:
Recent studies have shown that trimethylamine N-oxide (TMAO) is a risk factor for cardiovascular disease (CVD) in different clinical settings, but few studies confirmed the association in a community-based general population.
METHODS:
This is a nested case-control study from a prospective cohort design. A total of 86 newly diagnosed CVD cases with a median follow-up period of 4.83 years and 86 matched controls were selected for the present analysis.
RESULTS:
Using the LC-MS/MS assays, we found that new CVD cases had a higher baseline levels of TMAO than controls [median (inter-quartile): 1.57 (0.79-2.29) μmol/L v.s 0.68 (0.23-1.40) μmol/L, p < 0.001]. After multivariable adjustment, individuals with TMAO ≥1.89 μmol/L (Q4) and 1.05-1.89 μmol/L (Q3) had odds ratio (OR) for CVD of 2.735 [95% confidence interval (CI): 1.328-5.630] and 2.544 (95% CI: 1.251-5.172) with the lowest quartile (<0.43 μmol/L) as reference. In addition, comparisons of areas under receiver operator characteristics curves confirmed that a model including TMAO had a better discrimination than one without (0.732 vs. 0.664, p = 0.045).
CONCLUSIONS:
In the community-based general population, there was a positive association between TMAO and future risk of CVD. Addition of TMAO improved the prediction of CVD beyond traditional risk factors. We recommend considering TMAO as a potential novel preventive target in the management of low-risk CVD adults.
KEYWORDS:
Cardiovascular disease; General population; Nested case-control study; Trimethylamine N-oxide

Benefits and Harms of Antihypertensive Treatment in Low-Risk Patients With Mild Hypertension.
Sheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs FDR, McManus RJ.
JAMA Intern Med. 2018 Oct 29. doi: 10.1001/jamainternmed.2018.4684. [Epub ahead of print]
PMID: 30383082
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2708195?guestAccessKey=0215a663-f324-4bd3-bd21-f688e7028c06&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=120518
Abstract
IMPORTANCE:
Evidence to support initiation of pharmacologic treatment in low-risk patients with mild hypertension is inconclusive, with previous trials underpowered to demonstrate benefit. Clinical guidelines across the world are contradictory.
OBJECTIVE:
To examine whether antihypertensive treatment is associated with a low risk of mortality and cardiovascular disease (CVD) in low-risk patients with mild hypertension.
DESIGN, SETTING, AND PARTICIPANTS:
In this longitudinal cohort study, data were extracted from the Clinical Practice Research Datalink, from January 1, 1998, through September 30, 2015, for patients aged 18 to 74 years who had mild hypertension (untreated blood pressure of 140/90-159/99 mm Hg) and no previous treatment. Anyone with a history of CVD or CVD risk factors was excluded. Patients exited the cohort if follow-up records became unavailable or they experienced an outcome of interest.
EXPOSURES:
Prescription of antihypertensive medication. Propensity scores for likelihood of treatment were constructed using a logistic regression model. Individuals treated within 12 months of diagnosis were matched to untreated patients by propensity score using the nearest-neighbor method.
MAIN OUTCOMES AND MEASURES:
The rates of mortality, CVD, and adverse events among patients prescribed antihypertensive treatment at baseline, compared with those who were not prescribed such treatment, using Cox proportional hazards regression.
RESULTS:
A total of 19 143 treated patients (mean [SD] age, 54.7 [11.8] years; 10 705 [55.9%] women; 10 629 [55.5%] white) were matched to 19 143 similar untreated patients (mean [SD] age, 54.9 [12.2] years; 10 631 [55.5%] female; 10 654 [55.7%] white). During a median follow-up period of 5.8 years (interquartile range, 2.6-9.0 years), no evidence of an association was found between antihypertensive treatment and mortality (hazard ratio {HR}, 1.02; 95% CI, 0.88-1.17) or between antihypertensive treatment and CVD (HR, 1.09; 95% CI, 0.95-1.25). Treatment was associated with an increased risk of adverse events, including hypotension (HR, 1.69; 95% CI, 1.30-2.20; number needed to harm at 10 years [NNH10], 41), syncope (HR, 1.28; 95% CI, 1.10-1.50; NNH10, 35), electrolyte abnormalities (HR, 1.72; 95% CI, 1.12-2.65; NNH10, 111), and acute kidney injury (HR, 1.37; 95% CI, 1.00-1.88; NNH10, 91).
CONCLUSIONS AND RELEVANCE:
This prespecified analysis found no evidence to support guideline recommendations that encourage initiation of treatment in patients with low-risk mild hypertension. There was evidence of an increased risk of adverse events, which suggests that physicians should exercise caution when following guidelines that generalize findings from trials conducted in high-risk individuals to those at lower risk.

Association of Frequency of Organic Food Consumption With Cancer Risk: Findings From the NutriNet-Santé Prospective Cohort Study.
Baudry J, Assmann KE, Touvier M, Allès B, Seconda L, Latino-Martel P, Ezzedine K, Galan P, Hercberg S, Lairon D, Kesse-Guyot E.
JAMA Intern Med. 2018 Oct 22. doi: 10.1001/jamainternmed.2018.4357. [Epub ahead of print]
PMID: 30422212
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2707948?guestAccessKey=2e8694bf-5343-42e1-a7ad-097b04e4c114&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=120518
Key Points
Question  What is the association between an organic food–based diet (ie, a diet less likely to contain pesticide residues) and cancer risk?
Findings  In a population-based cohort study of 68 946 French adults, a significant reduction in the risk of cancer was observed among high consumers of organic food.
Meaning  A higher frequency of organic food consumption was associated with a reduced risk of cancer; if the findings are confirmed, research investigating the underlying factors involved with this association is needed to implement adapted and targeted public health measures for cancer prevention.
Abstract
Importance  Although organic foods are less likely to contain pesticide residues than conventional foods, few studies have examined the association of organic food consumption with cancer risk.
Objective  To prospectively investigate the association between organic food consumption and the risk of cancer in a large cohort of French adults.
Design, Setting, and Participants  In this population-based prospective cohort study among French adult volunteers, data were included from participants with available information on organic food consumption frequency and dietary intake. For 16 products, participants reported their consumption frequency of labeled organic foods (never, occasionally, or most of the time). An organic food score was then computed (range, 0-32 points). The follow-up dates were May 10, 2009, to November 30, 2016.
Main Outcomes and Measures  This study estimated the risk of cancer in association with the organic food score (modeled as quartiles) using Cox proportional hazards regression models adjusted for potential cancer risk factors.
Results  Among 68 946 participants (78.0% female; mean [SD] age at baseline, 44.2 [14.5] years), 1340 first incident cancer cases were identified during follow-up, with the most prevalent being 459 breast cancers, 180 prostate cancers, 135 skin cancers, 99 colorectal cancers, 47 non-Hodgkin lymphomas, and 15 other lymphomas. High organic food scores were inversely associated with the overall risk of cancer (hazard ratio for quartile 4 vs quartile 1, 0.75; 95% CI, 0.63-0.88; P for trend = .001; absolute risk reduction, 0.6%; hazard ratio for a 5-point increase, 0.92; 95% CI, 0.88-0.96).
Conclusions and Relevance  A higher frequency of organic food consumption was associated with a reduced risk of cancer. If these findings are confirmed, further research is necessary to determine the underlying factors involved in this association.
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Organic Foods for Cancer Prevention-Worth the Investment?
Hemler EC, Chavarro JE, Hu FB.
JAMA Intern Med. 2018 Oct 22. doi: 10.1001/jamainternmed.2018.4363. [Epub ahead of print] No abstract available.
PMID: 30422205
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2707943?guestAccessKey=c4e05604-c9f7-4c63-b6ba-0eaba017a6b7&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=120518

Edited by AlPater

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Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.
Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, AlAbdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L.
Cochrane Database Syst Rev. 2018 Nov 30;11:CD003177. doi: 10.1002/14651858.CD003177.pub4. Review.
PMID: 30521670
Abstract
BACKGROUND:
Researchers have suggested that omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this.
OBJECTIVES:
To assess effects of increased intake of fish- and plant-based omega-3 for all-cause mortality, cardiovascular (CVD) events, adiposity and lipids.
SEARCH METHODS:
We searched CENTRAL, MEDLINE and Embase to April 2017, plus ClinicalTrials.gov and World Health Organization International Clinical Trials Registry to September 2016, with no language restrictions. We handsearched systematic review references and bibliographies and contacted authors.
SELECTION CRITERIA:
We included randomised controlled trials (RCTs) that lasted at least 12 months and compared supplementation and/or advice to increase LCn3 or ALA intake versus usual or lower intake.
DATA COLLECTION AND ANALYSIS:
Two review authors independently assessed studies for inclusion, extracted data and assessed validity. We performed separate random-effects meta-analysis for ALA and LCn3 interventions, and assessed dose-response relationships through meta-regression.
MAIN RESULTS:
We included 79 RCTs (112,059 participants) in this review update and found that 25 were at low summary risk of bias. Trials were of 12 to 72 months' duration and included adults at varying cardiovascular risk, mainly in high-income countries. Most studies assessed LCn3 supplementation with capsules, but some used LCn3- or ALA-rich or enriched foods or dietary advice compared to placebo or usual diet. LCn3 doses ranged from 0.5g/d LCn3 to > 5 g/d (16 RCTs gave at least 3g/d LCn3).Meta-analysis and sensitivity analyses suggested little or no effect of increasing LCn3 on all-cause mortality (RR 0.98, 95% CI 0.90 to 1.03, 92,653 participants; 8189 deaths in 39 trials, high-quality evidence), cardiovascular mortality (RR 0.95, 95% CI 0.87 to 1.03, 67,772 participants; 4544 CVD deaths in 25 RCTs), cardiovascular events (RR 0.99, 95% CI 0.94 to 1.04, 90,378 participants; 14,737 people experienced events in 38 trials, high-quality evidence), coronary heart disease (CHD) mortality (RR 0.93, 95% CI 0.79 to 1.09, 73,491 participants; 1596 CHD deaths in 21 RCTs), stroke (RR 1.06, 95% CI 0.96 to 1.16, 89,358 participants; 1822 strokes in 28 trials) or arrhythmia (RR 0.97, 95% CI 0.90 to 1.05, 53,796 participants; 3788 people experienced arrhythmia in 28 RCTs). There was a suggestion that LCn3 reduced CHD events (RR 0.93, 95% CI 0.88 to 0.97, 84,301 participants; 5469 people experienced CHD events in 28 RCTs); however, this was not maintained in sensitivity analyses - LCn3 probably makes little or no difference to CHD event risk. All evidence was of moderate GRADE quality, except as noted.Increasing ALA intake probably makes little or no difference to all-cause mortality (RR 1.01, 95% CI 0.84 to 1.20, 19,327 participants; 459 deaths, 5 RCTs),cardiovascular mortality (RR 0.96, 95% CI 0.74 to 1.25, 18,619 participants; 219 cardiovascular deaths, 4 RCTs), and CHD mortality (1.1% to 1.0%, RR 0.95, 95% CI 0.72 to 1.26, 18,353 participants; 193 CHD deaths, 3 RCTs) and ALA may make little or no difference to CHD events (RR 1.00, 95% CI 0.80 to 1.22, 19,061 participants, 397 CHD events, 4 RCTs, low-quality evidence). However, increased ALA may slightly reduce risk of cardiovascular events (from 4.8% to 4.7%, RR 0.95, 95% CI 0.83 to 1.07, 19,327 participants; 884 CVD events, 5 RCTs, low-quality evidence with greater effects in trials at low summary risk of bias), and probably reduces risk of arrhythmia (3.3% to 2.6%, RR 0.79, 95% CI 0.57 to 1.10, 4,837 participants; 141 events, 1 RCT). Effects on stroke are unclear.Sensitivity analysis retaining only trials at low summary risk of bias moved effect sizes towards the null (RR 1.0) for all LCn3 primary outcomes except arrhythmias, but for most ALA outcomes, effect sizes moved to suggest protection. LCn3 funnel plots suggested that adding in missing studies/results would move effect sizes towards null for most primary outcomes. There were no dose or duration effects in subgrouping or meta-regression.There was no evidence that increasing LCn3 or ALA altered serious adverse events, adiposity or lipids, except LCn3 reduced triglycerides by ˜15% in a dose-dependant way (high-quality evidence).
AUTHORS' CONCLUSIONS:
This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and high-quality evidence suggests that increasing EPA and DHA has little or no effect on mortality or cardiovascular health (evidence mainly from supplement trials). Previous suggestions of benefits from EPA and DHA supplements appear to spring from trials with higher risk of bias. Low-quality evidence suggests ALA may slightly reduce CVD event and arrhythmia risk.

Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women With Normal Body Mass Index: A Secondary Analysis of a Randomized Clinical Trial and Observational Study.
Iyengar NM, Arthur R, Manson JE, Chlebowski RT, Kroenke CH, Peterson L, Cheng TD, Feliciano EC, Lane D, Luo J, Nassir R, Pan K, Wassertheil-Smoller S, Kamensky V, Rohan TE, Dannenberg AJ.
JAMA Oncol. 2018 Dec 6. doi: 10.1001/jamaoncol.2018.5327. [Epub ahead of print]
PMID: 30520976
Abstract
IMPORTANCE:
Obesity is associated with an increased risk of breast cancer, including the estrogen receptor (ER)-positive subtype in postmenopausal women. Whether excess adiposity is associated with increased risk in women with a normal body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) is unknown.
OBJECTIVE:
To investigate the association between body fat and breast cancer risk in women with normal BMI.
DESIGN, SETTING, AND PARTICIPANTS:
This ad hoc secondary analysis of the Women's Health Initiative (WHI) clinical trial and observational study cohorts was restricted to postmenopausal participants with a BMI ranging from 18.5 to 24.9. Women aged 50 to 79 years were enrolled from October 1, 1993, through December 31, 1998. Of these, 3460 participants underwent body fat measurement with dual-energy x-ray absorptiometry (DXA) at 3 US designated centers with follow-up. At a median follow-up of 16 years (range, 9-20 years), 182 incident breast cancers had been ascertained, and 146 were ER positive. Follow-up was complete on September 30, 2016, and data from October 1, 1993, through September 30, 2016, was analyzed August 2, 2017, through August 21, 2018.
MAIN OUTCOMES AND MEASURES:
Body fat levels were measured at baseline and years 1, 3, 6, and 9 using DXA. Information on demographic data, medical history, and lifestyle factors was collected at baseline. Invasive breast cancers were confirmed via central review of medical records by physician adjudicators. Blood analyte levels were measured in subsets of participants.
RESULTS:
Among the 3460 women included in the analysis (mean [SD] age, 63.6 [7.6] years), multivariable-adjusted hazard ratios for the risk of invasive breast cancer were 1.89 (95% CI, 1.21-2.95) for the highest quartile of whole-body fat and 1.88 (95% CI, 1.18-2.98) for the highest quartile of trunk fat mass. The corresponding adjusted hazard ratios for ER-positive breast cancer were 2.21 (95% CI, 1.23-3.67) and 1.98 (95% CI, 1.18-3.31), respectively. Similar positive associations were observed for serial DXA measurements in time-dependent covariate analyses. Circulating levels of insulin, C-reactive protein, interleukin 6, leptin, and triglycerides were higher, whereas levels of high-density lipoprotein cholesterol and sex hormone-binding globulin were lower in those in the uppermost vs lowest quartiles of trunk fat mass.
CONCLUSIONS AND RELEVANCE:
In postmenopausal women with normal BMI, relatively high body fat levels were associated with an elevated risk of invasive breast cancer and altered levels of circulating metabolic and inflammatory factors. Normal BMI categorization may be an inadequate proxy for the risk of breast cancer in postmenopausal women.

Effect of a Whey Protein Supplement on Preservation of Fat Free Mass in Overweight and Obese Individuals on an Energy Restricted Very Low Caloric Diet.
Larsen AE, Bibby BM, Hansen M.
Nutrients. 2018 Dec 4;10(12). pii: E1918. doi: 10.3390/nu10121918.
PMID: 30518130
Abstract
The obesity epidemic has caused a widespread interest in strategies to achieve a healthy "high quality" weight loss, where excess fat is lost, while fat free mass (FFM) is preserved. In this study, we aimed to examine the effect of whey protein supplementation given before night sleep on FFM preservation during a 4-week (wk) period on a very low caloric diet (VLCD). Twenty-nine obese subjects (body mass index (BMI) > 28 kg/m²) completed a 4-week intervention including a VLCD and a walking program (30 min walking × 5 times per week). Subjects were randomly assigned to either control (CON, n = 15) or a whey protein supplement (PRO, 0.4 g protein/kg/day, n = 14), ingested before bedtime. Body composition (dual-energy X-ray absorptiometry, DXA), blood analysis and physical test were performed pre and post intervention. We measured nitrogen excretion in three 24 h urine collections (Day 0, 7 and 28) to assess nitrogen balance. Changes in nitrogen balance (NB) after 7 and 28 days was different between treatment groups (interaction p < 0.05). PRO was in NB after 7 days and in positive NB at day 28. In contrast, CON was in negative NB at day 7, but in NB at day 28. Nevertheless, no significant group differences were observed in the change in pre- and post-FFM measurements (-2.5 kg, [95% CI: 1.9; 3.1], p = 0.65). In conclusion, ingestion of a whey protein supplement before bedtime during a 4-week period on a VLCD improved nitrogen balance, but did not lead to any significant improvement in the quality of the weight loss in regard to observed changes in body composition and health parameters compared with controls.
KEYWORDS:
FFM; VLCD; body composition; protein supplement; weight loss

Three-Year Chronic Consumption of Low-Carbohydrate Diet Impairs Exercise Performance and Has a Small Unfavorable Effect on Lipid Profile in Middle-Aged Men.
Pilis K, Pilis A, Stec K, Pilis W, Langfort J, Letkiewicz S, Michalski C, Czuba M, Zych M, Chalimoniuk M.
Nutrients. 2018 Dec 4;10(12). pii: E1914. doi: 10.3390/nu10121914.
PMID: 30518095
https://www.mdpi.com/2072-6643/10/12/1914/htm
Abstract
The objective of this research was to determine whether chronic (average 3.58 ± 1.56 years) deliberate adherence to low carbohydrate diets (LCDs) is associated with selected markers of metabolism, risk factors of cardiovascular disease (CVD), body mass and physical performance in apparently healthy middle-aged men (n = 12). The control group comprised age, body mass and height matched men using mixed diets (MDs). The diets used were registered for 7 days and analyzed in terms of the energy, carbohydrate, fat and protein contents. It was found that the diets used were isoenergetic, yet varied considerably in carbohydrate and fat content. The LCDs significantly intensified the ketogenesis process, increased resting blood total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and heart rate, (HR) and decreased respiratory exchange ratio (RER) in relation to MD subjects. An exercise trial revealed significant impairment of exercise in subjects following the LCDs. The results showed that in the case where the subjects of two investigated groups did not differ in their somatic variables, long-term adherence to the LCDs was associated with substantially reduced exercise performance in apparently healthy subjects, along with an association with a small unfavorable effect on their lipid profile.
KEYWORDS:
carbohydrate restriction; cardiovascular disease; diets; men; metabolism

Effects of Arachidonic and Docosohexahenoic Acid Supplementation during Gestation in Rats. Implication of Placental Oxidative Stress.
Reyes-Hernández CG, Ramiro-Cortijo D, Rodríguez-Rodríguez P, Giambelluca S, Simonato M, González MDC, López de Pablo AL, López-Giménez MDR, Cogo P, Sáenz de Pipaón M, Carnielli VP, Arribas SM.
Int J Mol Sci. 2018 Dec 4;19(12). pii: E3863. doi: 10.3390/ijms19123863.
PMID: 30518038
https://www.mdpi.com/1422-0067/19/12/3863/htm
Abstract
Arachidonic and docosahexaenoic acids (ARA and DHA) are important during pregnancy. However, the effects of dietary supplementation on fetal growth and oxidative stress are inconclusive. We aimed to assess the effect of high ARA and DHA diet during rat gestation on: (1) ARA and DHA availability in plasma and placenta, (2) fetal growth, and (3) placental oxidative stress, analyzing the influence of sex. Experimental diet (ED) was prepared by substituting soybean oil in the control diet (CD) by a fungi/algae-based oil containing ARA and DHA (2:1). Rats were fed with CD or ED during gestation; plasma, placenta, and fetuses were obtained at gestational day 20. DHA, ARA, and their precursors were analyzed in maternal plasma and placenta by gas chromatography/mass spectrophotometry. Fetuses and placentas were weighed, the proportion of fetuses with intrauterine growth restriction (IUGR) determined, and placental lipid and protein oxidation analyzed. ED fetuses exhibited lower body weight compared to CD, being >40% IUGR; fetal weight negatively correlated with maternal plasma ARA, but not DHA. Only ED female placenta exhibited higher lipid and protein oxidation compared to its CD counterparts; lipid peroxidation is negatively associated with fetal weight. In conclusion, high ARA during gestation associates with IUGR, through placental oxidative stress, with females being more susceptible.
KEYWORDS:
ARA; DHA; IUGR; fetus; oxidative stress; placenta

Implications of amino acid sensing and dietary protein to the aging process.
Lushchak O, Strilbytska OM, Yurkevych I, Vaiserman AM, Storey KB.
Exp Gerontol. 2018 Nov 28. pii: S0531-5565(18)30467-4. doi: 10.1016/j.exger.2018.11.021. [Epub ahead of print] Review.
PMID: 30502540
https://sci-hub.tw/10.1016/j.exger.2018.11.021
Abstract
Every organism must adapt and respond appropriately to the source of nutrients available in its environment. Different mechanisms and pathways are involved in detecting the intracellular and extracellular levels of macronutrients including amino acids. Detection of amino acids in food sources is provided by taste cells expressing T1R1 and T1R3 type receptors. Additionally, cells of the intestine, pancreas or heart sense amino acids extracellularly. Neuronal and hormonal regulation integrates and coordinates the signals at the organismal level. Amino acid-sensitive mechanisms including GCN2 protein, mTOR and LYNUS machinery adjust cellular process according to the availability of specific amino acids. Triggering these mechanisms by genetic manipulations or by external manipulations with diets has a significant impact on lifespan. In model organisms, the restriction of protein or specific amino acids within the diet leads to lifespan-extending effects. However, the translation of results from model organisms to application in humans has to take into account lifestyle, psychology, social aspects and the possibility to choose what to eat and how it is cooked.
KEYWORDS:
Aging; Amino acids; Macronutrients; Sensing

https://nepis.epa.gov/Exe/ZyPDF.cgi/9100RY6A.PDF?Dockey=9100RY6A.PDF
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Dietary cadmium and risk of breast cancer subtypes defined by hormone receptor status: a prospective cohort study.
Grioni S, Agnoli C, Krogh V, Pala V, Rinaldi S, Vinceti M, Contiero P, Vescovi L, Malavolti M, Sieri S.
Int J Cancer. 2018 Dec 4. doi: 10.1002/ijc.32039. [Epub ahead of print]
PMID: 30515770
Abstract
Diet is the primary source of cadmium - a proven Group 1 human carcinogen - for non-smokers. Observational studies investigating the effect of cadmium from food sources on breast cancer risk have produced inconsistent results. We examined the association between dietary cadmium and risk of breast cancer defined by estrogen receptor (ER), progesterone receptor (PR) and HER2 status, in 8,924 women recruited to a prospective study between 1987 and 1992. Dietary cadmium intake was estimated using a semi-quantitative food frequency questionnaire at baseline. During a median of 22 years of follow-up, 451 incident cases of breast cancer were identified through the Varese Cancer Registry. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for breast cancer and receptor-defined breast cancer subtypes were estimated for quintiles of dietary cadmium intake, adjusting for confounding factors. Mean dietary cadmium intake was 7.8 (standard deviation 1.4) μg/day. Women with highest quintile of cadmium intake had a greater risk of breast cancer (HR 1.54; 95% CI, 1.06 - 2.22; p-trend = 0.028) than those with lowest quintile of intake. Women premenopausal at recruitment had HR = 1.73 (95% CI, 1.10 - 2.71, highest vs. lowest quintile); postmenopausal women had HR = 1.32 (95% CI, 1.05 - 1.66 for each standard deviation increase in cadmium). Cadmium-related risk of breast cancer did not vary with ER, PR or HER2 status (p-heterogeneity not significant). These findings support the hypothesis that dietary cadmium is a risk factor for breast cancer. This article is protected by copyright. All rights reserved.
KEYWORDS:
Cadmium; HER2; breast cancer; estrogen receptors; progesterone receptors

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Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis.
Iguacel I, Miguel-Berges ML, Gómez-Bruton A, Moreno LA, Julián C.
Nutr Rev. 2019 Jan 1;77(1):1-18. doi: 10.1093/nutrit/nuy045.
PMID: 30376075
[Free pdf Production in progress]
Abstract
CONTEXT:
The numbers of vegans and vegetarians have increased in the last decades. However, the impact of these diets on bone health is still under debate.
OBJECTIVE:
This systematic review and meta-analysis sought to study the impact of vegetarian and vegan diets on bone mineral density (BMD) and fracture risk.
DATA SOURCES:
A systematic search was conducted of PubMed, Scopus, and Science Direct, covering the period from the respective start date of each database to November 2017.
DATA EXTRACTION:
Two investigators evaluated 275 studies against the inclusion criteria (original studies in humans, written in English or Spanish and including vegetarian or vegan diets and omnivorous diets as factors with BMD values for the whole body, lumbar spine, or femoral neck and/or the number of fractures as the outcome) and exclusion criteria (articles that did not include imaging or studies that included participants who had suffered a fracture before starting the vegetarian or vegan diet). The quality assessment tool for observational cohort and cross-sectional studies was used to assess the quality of the studies.
RESULTS:
Twenty studies including 37 134 participants met the inclusion criteria. Compared with omnivores, vegetarians and vegans had lower BMD at the femoral neck and lumbar spine and vegans also had higher fracture rates.
CONCLUSIONS:
Vegetarian and vegan diets should be planned to avoid negative consequences on bone health.

Resveratrol supplementation significantly influences obesity measures: a systematic review and dose-response meta-analysis of randomized controlled trials.
Mousavi SM, Milajerdi A, Sheikhi A, Kord-Varkaneh H, Feinle-Bisset C, Larijani B, Esmaillzadeh A.
Obes Rev. 2018 Dec 5. doi: 10.1111/obr.12775. [Epub ahead of print] Review.
PMID: 30515938
Abstract
This study aimed to summarize earlier randomized controlled trials on the effects of resveratrol supplementation on body weight (BW), body mass index (BMI), waist circumference (WC) and fat mass (FM). We searched PubMed, SCOPUS, Cochrane Library and Google Scholar from inception to April 2018 using relevant keywords. All clinical trials investigating the effects of resveratrol supplementation on BW, BMI, WC and FM in adults were included. Overall, 28 trials were included. Pooled effect sizes suggested a significant effect of resveratrol administration on weight (weighted mean differences [WMD]: -0.51 kg, 95% confidence interval [CI]: -0.94 to -0.09; I2  = 50.3%, P = 0.02), BMI (WMD: -0.17 kg m-2 , 95% CI: -0.32, -0.03; I2  = 49.6%, P = 0.02) and WC (WMD: -0.79 cm, 95% CI: -1.39, -0.2; I2  = 13.4%, P = 0.009), respectively. However, no significant effect of resveratrol supplementation on FM was found (WMD: -0.36%, 95% CI: -0.88, 0.15; I2  = 0.0%, P = 0.16). Findings from subgroup analysis revealed a significant reduction in BW and BMI in trials using resveratrol at the dosage of <500 mg d-1 , those with long-term interventions (≥3 month), and performed on people with obesity. Taken together, the data suggest that resveratrol supplementation has beneficial effects to reduce BW, BMI and WC, but not FM.
KEYWORDS:
dose-response; meta-analysis; obesity; resveratrol; weight

Effect of S-equol and soy isoflavones on heart and brain.
Sekikawa A, Ihara M, Lopez O, Kakuta C, Lopresti B, Higashiyama A, Aizenstein H, Chang YF, Mathis C, Miyamoto Y, Kuller L, Cui C.
Curr Cardiol Rev. 2018 Dec 4. doi: 10.2174/1573403X15666181205104717. [Epub ahead of print]
PMID: 30516108
Abstract
BACKGROUND:
Observational studies in Asia show that dietary intake of soy isoflavones had a significant inverse association with coronary heart disease (CHD). A recent randomized controlled trial (RCT) of soy isoflavones on atherosclerosis in the US, however, failed to show their benefit. The discrepancy may be due to the much lower prevalence of S-equol producers in Westerners: Only 20-30% of Westerners produce S-equol in contrast to 50-70% in Asians. S-equol is a metabolite of dietary soy isoflavone daidzein by gut microbiome and possesses the most anti-atherogenic properties among all isoflavones. Several short-duration RCTs documented that soy isoflavones improves arterial stiffness. Accumulating evidence shows that both atherosclerosis and arterial stiffness are positively associated with cognitive decline/dementia. Therefore, potentially, soy isoflavones, especially S-equol, are protective against cognitive decline/dementia.
METHODS/RESULTS:
This narrative review of clinical and epidemiological studies provides an overview of the health benefits of soy isoflavones and introduces S-equol. Second, we review recent evidence on the association of soy isoflavones and S-equol with CHD, atherosclerosis, and arterial stiffness as well as the association of atherosclerosis and arterial stiffness with cognitive decline/dementia. Third, we highlight recent studies that report the association of soy isoflavones and S-equol with cognitive decline/dementia. Lastly, we discuss the future directions of clinical and epidemiological research on the relationship of S-equol and CHD and dementia.
CONCLUSIONS:
Evidence from observational studies and short-term RCTs suggests that S-equol is anti-atherogenic and improves arterial stiffness and may prevent CHD and cognitive impairment/dementia. Well-designed long-term (≥ 2years) RCTs should be pursued.

Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women.
Gordon JH, LaMonte MJ, Zhao J, Genco RJ, Cimato TR, Hovey KM, Allison MA, Mouton CP, Wactawski-Wende J.
Am J Hypertens. 2018 Dec 4. doi: 10.1093/ajh/hpy164. [Epub ahead of print]
PMID: 30517596
Abstract
BACKGROUND:
Multiple cross-sectional epidemiologic studies have suggested an association between periodontal disease and tooth loss and hypertension, but the temporality of these associations remains unclear. The objective of our study was to evaluate the association of baseline self-reported periodontal disease and edentulism with incident hypertension.
METHODS:
Study participants were 36,692 postmenopausal women in the Women's Health Initiative-Observational Study who were followed annually from initial periodontal assessment (1998-2003) through 2015 (mean follow-up 8.3 years) for newly diagnosed treated hypertension. Cox proportional hazards regression with adjustment for potential confounders was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS:
Edentulism was significantly associated with incident hypertension in crude (HR (95% CI) = 1.38 (1.28-1.49)) and adjusted (HR (95% CI) = 1.21 (1.11-1.30)) models. This association was stronger among those <60 years compared to ≥60 years (P interaction 0.04) and among those with <120 mm Hg systolic blood pressure, compared to those with ≥120 mm Hg (P interaction 0.004). No association was found between periodontal disease and hypertension.
CONCLUSIONS:
These findings suggest that edentulous postmenopausal women may represent a group with higher risk of developing future hypertension. As such improved dental hygiene among those at risk for tooth loss as well as preventive measures among the edentulous such as closer blood pressure monitoring, dietary modification, physical activity, and weight loss may be warranted to reduce disease burden of hypertension. Further studies are needed to clarify these results and further elucidate a potential role of periodontal conditions on hypertension risk.

Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health.
He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR.
Int J Epidemiol. 2018 Dec 1;47(6):1784-1795. doi: 10.1093/ije/dyy114.
PMID: 30517688
Abstract
BACKGROUND:
Several cohort studies with inaccurate estimates of sodium reported a J-shaped relationship with mortality. We compared various estimated sodium intakes with that measured by the gold-standard method of multiple non-consecutive 24-h urine collections and assessed their relationship with mortality.
METHODS:
We analysed the Trials of Hypertension Prevention follow-up data. Sodium intake was assessed in four ways: (i) average measured (gold standard): mean of three to seven 24-h urinary sodium measurements during the trial periods; (ii) average estimated: mean of three to seven estimated 24-h urinary sodium excretions from sodium concentration of 24-h urine using the Kawasaki formula; (iii) first measured: 24-h urinary sodium measured at the beginning of each trial; (iv) first estimated: 24-h urinary sodium estimated from sodium concentration of the first 24-h urine using the Kawasaki formula. We included 2974 individuals aged 30-54 years with pre-hypertension, not assigned to sodium intervention.
RESULTS:
During a median follow-up of 24 years, 272 deaths occurred. The average sodium intake measured by the gold-standard method was 3769 ± 1282 mg/d. The average estimated sodium over-estimated the intake by 1297 mg/d (95% confidence interval: 1267-1326). The average estimated value was systematically biased with over-estimation at lower levels and under-estimation at higher levels. The average measured sodium showed a linear relationship with mortality. The average estimated sodium appeared to show a J-shaped relationship with mortality. The first measured and the first estimated sodium both flattened the relationship.
CONCLUSIONS:
Accurately measured sodium intake showed a linear relationship with mortality. Inaccurately estimated sodium changed the relationship and could explain much of the paradoxical J-shaped findings reported in some cohort studies.

Unsaturated Fatty Acid Intakes During Midlife Are Positively Associated with Later Cognitive Function in Older Adults with Modulating Effects of Antioxidant Supplementation.
Assmann KE, Adjibade M, Hercberg S, Galan P, Kesse-Guyot E.
J Nutr. 2018 Dec 1;148(12):1938-1945. doi: 10.1093/jn/nxy206.
PMID: 30517725
https://sci-hub.tw/10.1093/jn/nxy206
Abstract
BACKGROUND:
Given the drastic demographic changes characterized as "population aging," the disease burden related to dementia is a major public health problem. The scientific literature documenting the link between mono- and polyunsaturated fatty acids (MUFAs, PUFAs) and cognitive function during aging is plentiful, but findings are inconsistent.
OBJECTIVES:
We aimed to evaluate the association between intakes of unsaturated fatty acids at midlife and cognitive performance 13 y later in French adults, and to test for a modulating effect of antioxidant supplementation.
METHODS:
Fatty acid intakes were estimated with the use of repeated 24-h records (1994-1996) among 3362 subjects (mean ± SD age: 65.5 ± 4.6 y) of the SU.VI.MAX (Supplementation with Antioxidant Vitamins and Minerals) study, including an intervention phase (1994-2002) during which participants were randomly assigned to an "antioxidant supplementation" or placebo group. Cognitive performance was assessed at follow-up only (in 2007-2009) via a battery of 6 standardized neuropsychological tests. A global cognitive score was calculated as the sum of T-scores of the 6 tests. Multivariable-adjusted regression analyses were performed to provide regression coefficients and 95% CIs.
RESULTS:
In multivariable models, total MUFAs, total PUFAs, and n-6 PUFAs (ω-6 PUFAs) were positively associated with overall cognitive functioning. n-3 PUFA (ω-3 PUFA) intakes showed positive associations among supplemented participants only (mean difference Tertile3 versus Tertile1: 1.40; 95% CI: 0.30, 2.51; P-trend = 0.01, P-interaction = 0.01). A detrimental role of arachidonic acid for cognitive functioning was only detected in the placebo group (mean difference Tertile3 versus Tertile1: -1.38; 95% CI: -2.57, -0.18; P-trend = 0.02, P-interaction = 0.07).
CONCLUSION:
Whereas higher total MUFA and n-6 PUFA intakes may be generally beneficial for maintaining cognitive health during aging, a higher consumption of n-3 fatty acids may only be beneficial among individuals with an adequate antioxidant status. These findings underline the importance of not only focusing on specific nutrients for dementia prevention, but also considering the complex interaction between consumed nutrients. 

Protein Intake and Risk of Falls: A Prospective Analysis in Older Adults.
Sandoval-Insausti H, Pérez-Tasigchana RF, López-García E, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P.
J Am Geriatr Soc. 2018 Dec 5. doi: 10.1111/jgs.15681. [Epub ahead of print]
PMID: 30517767
Abstract
BACKGROUND:
The prospective association between protein intake and falls has been little studied. We assessed this association in a Spanish community-dwelling cohort.
METHODS:
We performed a prospective cohort study of 2464 men and women 60 years or older who were recruited in 2008-2010 and followed up through 2012. At baseline, the habitual protein intake was determined with a validated dietary history. At the end of follow-up, participants reported the number of falls experienced in the preceding year. Participants were stratified by an unintentional weight loss of 4.5 kg or more. Logistic regression was used after adjustment for the main confounders.
RESULTS:
A total of 522 participants (21.2%) experienced at least one fall. The odds ratios (ORs) and 95% confidence intervals (CIs) of falling for the three increasing tertiles of total protein intake were 1.00, 0.86 (0.66-1.11), and 0.93 (0.70-1.24) (p for trend = 0.14). However, a statistically significant interaction with unintentional weight loss was observed for the association between protein intake and fall risk (p for interaction = 0.004). Among 163 participants (6.6%) who experienced unintentional weight loss, the ORs (95% CI) of falling for the three increasing tertiles of total protein intake were 1.00, 0.68 (0.21-2.23), and 0.23 (0.05-1.08) (p for trend = 0.01).
CONCLUSION:
No protective association between protein intake and fall risk in older adults was found. However, high total protein intake tended to confer substantial benefits to participants who experienced an unintentional weight loss of 4.5 kg or more in the preceding year.
KEYWORDS:
animal protein intake; falls; older adults; protein intake; unintentional weight loss; vegetable protein intake

Contributions of a high-fat diet to Alzheimer's disease-related decline: A longitudinal behavioural and structural neuroimaging study in mouse models.
Rollins CPE, Gallino D, Kong V, Ayranci G, Devenyi GA, Germann J, Chakravarty MM.
Neuroimage Clin. 2018 Nov 20. pii: S2213-1582(18)30354-1. doi: 10.1016/j.nicl.2018.11.016. [Epub ahead of print]
PMID: 30503215
https://www.sciencedirect.com/science/article/pii/S2213158218303541?via%3Dihub
https://ac.els-cdn.com/S2213158218303541/1-s2.0-S2213158218303541-main.pdf?_tid=2cb122d9-52c7-496d-ac9c-1ae8896cdffb&acdnat=1544455370_7792bb8ae70e168218db56e8d000532d
Abstract
Obesity is recognized as a significant risk factor for Alzheimer's disease (AD). Studies have supported that obesity accelerates AD-related pathophysiology and memory impairment in mouse models of AD. However, the nature of the brain structure-behaviour relationship mediating this acceleration remains unclear. In this manuscript we evaluated the impact of adolescent obesity on the brain morphology of the triple transgenic mouse model of AD (3xTg) and a non-transgenic control model of the same background strain (B6129s) using longitudinally acquired structural magnetic resonance imaging (MRI). At 8 weeks of age, animals were placed on a high-fat diet (HFD) or an ingredient-equivalent control diet (CD). Structural images were acquired at 8, 16, and 24 weeks. At 25 weeks, animals underwent the novel object recognition (NOR) task and the Morris water maze (MWM) to assess short-term non-associative memory and spatial memory, respectively. All analyses were carried out across four groups: B6129s-CD and -HFD and 3xTg-CD and -HFD. Neuroanatomical changes in MRI-derived brain morphology were assessed using volumetric and deformation-based analyses. HFD-induced obesity during adolescence exacerbated brain volume alterations by adult life in the 3xTg mouse model in comparison to control-fed mice and mediated volumetric alterations of select brain regions, such as the hippocampus. Further, HFD-induced obesity aggravated memory in all mice, lowering certain memory measures of B6129s control mice to the level of 3xTg mice maintained on a CD. Moreover, decline in the volumetric trajectories of hippocampal regions for all mice were associated with the degree of spatial memory impairments on the MWM. Our results suggest that obesity may interact with the brain changes associated with AD-related pathology in the 3xTg mouse model to aggravate brain atrophy and memory impairments and similarly impair brain structural integrity and memory capacity of non-transgenic mice. Further insight into this process may have significant implications in the development of lifestyle interventions for treatment of AD.

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Tennis tops list of sports for increasing life expectancy
Social connection might be the key to sport's longevity benefits
Australian Broadcasting Corporation · Posted: Dec 10, 2018
https://www.cbc.ca/news/health/sports-life-expectancy-1.4939918

Sarcopenia Definitions and Their Associations With Mortality in Older Australian Women.
Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth CA, Zhu K, Woodman RJ, Hodgson JM, Lewis JR.
J Am Med Dir Assoc. 2018 Dec 5. pii: S1525-8610(18)30590-5. doi: 10.1016/j.jamda.2018.10.016. [Epub ahead of print]
PMID: 30527277
Abstract
OBJECTIVES:
To investigate the relationship of 4 sarcopenia definitions with long-term all-cause mortality risk in older Australian women.
DESIGN:
Data from the Perth Longitudinal Study in Aging Women from 2003 to 2013 was examined in this prospective cohort study. The 4 sarcopenia definitions were the United States Foundation for the National Institutes of Health (FNIH), the European Working Group on Sarcopenia in Older People (EWGSOP), and adapted FNIH (AUS-POPF) and EWGSOP (AUS-POPE) definitions using Australian population-specific cut-points [<2 standard deviation (SD)] below the mean of young healthy Australian women. All-cause mortality was captured via linked data systems.
SETTING AND PARTICIPANTS:
In total, 903 community-dwelling older Australian women (baseline mean age 79.9 ± 2.6 years) with concurrent measures of muscle strength (grip strength), physical function (timed-up-and-go; TUG) and appendicular lean mass (ALM) were included.
MEASURES:
Cox-proportional hazards modeling was used to examine the relationship between sarcopenia definitions and mortality over 5 and 9.5 years.
RESULTS:
Baseline prevalence of sarcopenia by the 4 definitions differed substantially [FNIH (9.4%), EWGSOP (24.1%), AUS-POPF (12.0%), AUS-POPE (10.7%)]. EWGSOP and AUS-POPE had increased age-adjusted hazard ratios (aHRs) for mortality over 5 years [aHR 1.88 95% confidence interval (CI) (1.24‒2.85), P < .01; aHR 2.52 95% CI (1.55‒4.09), P < .01, respectively] and 9.5 years (aHR 1.39 95% CI (1.06‒1.81), P = .02; aHR 1.94 95% CI (1.40‒2.69), P < .01, respectively). No such associations were observed for FNIH or AUS-POPF. Sarcopenia components including weaker grip strength (per SD, 4.9 kg; 17%) and slower TUG (per SD, 3.1 seconds; 40%) but not ALM adjusted-variants (ALM/body mass index or ALM/height2) were associated with greater relative hazards for mortality over 9.5 years.
CONCLUSIONS/RELEVANCE:
Unlike FNIH, the EWGSOP sarcopenia definition incorporating weak muscle strength and/or poor physical function was related to prognosis, as was the regionally adapted version of EWGSOP. Although sarcopenia definitions were not developed based on prognosis, this is an important consideration for globally standardizing the sarcopenia framework.
KEYWORDS:
Mortality; geriatrics; lean mass; muscle strength; physical function

The tooth loss and mortality from all causes, cardiovascular diseases and coronary heart disease: Systematic review and dose-response meta-analysis.
Peng J, Song JK, Han J, Chen Z, Yin X, Zhu J, Song J.
Biosci Rep. 2018 Dec 7. pii: BSR20181773. doi: 10.1042/BSR20181773. [Epub ahead of print]
PMID: 30530864
http://www.bioscirep.org/content/ppbioscirep/early/2018/12/07/BSR20181773.full.pdf
Abstract
BACKGROUND:
The association of tooth loss with mortality from all causes, cardiovascular diseases (CVD), and coronary heart disease (CHD) has been studied for many years; however, the results are inconsistent.
METHOD:
PubMed, Embase, Web of Knowledge, and Cochrane Oral Health Group's Trials Register databases were searched for papers published from 1966 to August 2018. We conducted dose-response meta-analysis to quantitatively evaluate the relation between tooth loss and risk of mortality from all causes, CVD, and CHD.
RESULTS:
In this study, 18 prospective studies were considered eligible for analysis. In the analysis of linear association, the summarized relative risk (RR) values for each 10-, 20-, and 32-tooth loss for all-cause mortality were 1.15 (1.11-1.19), 1.33 (1.23-1.29), and 1.57 (1.39-1.51), respectively. Subgroup and sensitivity analyses showed consistent results. Subgroup and sensitivity analyses revealed inconsistent results. Tooth loss showed linear association with CHD mortality but not with CVD mortality. The susceptibility to all-cause mortality increased by almost 1.48 and 1.70 times for CVD and CHD, respectively, at very high tooth loss (28-32). The curve exhibited slight flattening; however, no statistical significance was detected.
CONCLUSION:
In the meta-analysis, our findings confirmed the positive relationship between tooth loss and susceptibility to all-cause mortality, but not for circulatory mortality.  Tooth loss may be a potential risk marker for all-cause mortality: however, their association must be further validated through large prospective studies.
KEYWORDS:
CardioVascular Diseases; Coronary Heart Disease; Mortality; Systematic Review; Tooth Loss
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Gerodontology. 2005 Dec;22(4):234-7.
Eight-year mortality associated with dental occlusion and denture use in community-dwelling elderly persons.
Yoshida M1, Morikawa H, Yoshikawa M, Tsuga K, Akagawa Y.
PMID: 16329232
Abstract
OBJECTIVE:
To evaluate the influence of dental occlusion, with or without the use of dentures, on mortality in community-dwelling elderly persons.
SUBJECTS:
A total of 1030 randomly selected healthy independent elderly aged 65 and over were surveyed in 1995. For the study reported here, subjects were classified into three groups according to the presence or absence of maxillo-mandibular tooth contacts. Subjects with no maxillo-mandibular tooth contacts were further subdivided into those with and without dentures.
METHODS:
Data on mortality were obtained from Kure City Council in September 2003. Cox regression models were used in analysing the risk for death with gender and age as covariates.
RESULTS:
Individuals whose teeth had contact in at least the bilateral premolar regions at baseline had 0.78 times (95% CI: 0.60-0.99) smaller risk for death during the succeeding 8 years than those who had no occlusion. Among those who had no occlusion with their own teeth, the risk for mortality among denture non-users was 1.52 times (95% CI: 1.25-1.83) higher than the risk for denture users.
CONCLUSION:
These results may support the view that, in the elderly; poor dental occlusion is associated with an increased risk for mortality and that, in the edentulous, the use of dentures is associated with a decreased risk for mortality.

Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population-based cohort study.
Fest J, Ruiter R, Mooijaart SP, Ikram MA, van Eijck CHJ, Stricker BH.
J Intern Med. 2018 Dec 9. doi: 10.1111/joim.12853. [Epub ahead of print]
PMID: 30537394
https://sci-hub.tw/10.1111/joim.12853
Abstract
BACKGROUND:
A very high erythrocyte sedimentation rate (ESR) is usually an indication of underlying pathology. Additionally, a moderately elevated ESR may also be attributable to biological ageing. Whether the ESR is a prognostic factor for mortality, regardless of age, has been scarcely investigated. Therefore, the objective was to analyse the association between elevated ESR levels and the risk of mortality in a prospective cohort of the general population.
METHODS:
We studied data from the Rotterdam Study (1990-2014). ESR levels were measured at baseline and individuals were followed until death or end of study. Associations between moderately (20-50 mm h-1 ) and markedly (>50 mm h-1 ) elevated ESR levels and all-cause mortality were assessed using multivariate Cox proportional hazard models.
RESULTS:
In total, 5226 participants were included, and the mean age was 70.3 years. During a median follow-up time of 14.9 years, 3749 participants died (71.7%). After adjustment, both a moderately elevated ESR and a markedly elevated ESR were associated with a significantly higher risk of overall mortality [hazard ratio (HR) 1.23, 95% confidence interval (CI) 1.12-1.35 and HR 1.89, 95% CI 1.38-2.60, respectively]. Although the ESR becomes higher with age, in a group aged above 75 years, without any comorbidities, an ESR > 20 mm h-1 remained associated with a significantly increased risk of mortality (HR 1.29, 95%CI 1.01-1.64).
CONCLUSION:
An elevated ESR is an independent prognostic factor for mortality. Despite the fact that ESR increases with age, it remains associated with an increased risk of mortality and warrants close follow-up.
KEYWORDS:
ageing; erythrocyte sedimentation rate; general population; low-grade inflammation; mortality

Social determinants, health status and 10-year mortality among 10,906 older adults from the English longitudinal study of aging: the ATHLOS project.
Kollia N, Caballero FF, Sánchez-Niubó A, Tyrovolas S, Ayuso-Mateos JL, Haro JM, Chatterji S, Panagiotakos DB.
BMC Public Health. 2018 Dec 10;18(1):1357. doi: 10.1186/s12889-018-6288-6.
PMID: 30526556
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-6288-6
https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-018-6288-6
Abstract
BACKGROUND:
In either rich or poor countries, people's health widely depends on the social conditions in which they live and work - the social determinants of health. The aim of the present work was to explore the association of educational and financial status with healthy aging and mortality.
METHODS:
Data from the English Longitudinal Study of Aging (ELSA) were studied (n = 10,906 participants, 64 ± 11 years, 55% women). A set of 45 self-reported health items and measured tests were used to generate a latent health metric reflecting levels of functioning referred to as health metric (higher values indicated better health status). Overall mortality after 10-years of follow-up (2002-2012) was recorded.
RESULTS:
Both education and household wealth over time were positively associated with the health metric (p < 0.001) and negatively with overall mortality (p < 0.001). Lifestyle behaviors (i.e., physical activity, smoking habits and alcohol consumption) mediated the effect of education and household wealth on the health metric and the latter mediated their effect on overall mortality.
CONCLUSIONS:
In conclusion, reducing socioeconomic disparities in health by improving the access to education and by providing financial opportunities should be among the priorities in improving the health of older adults.
KEYWORDS:
Education; Financial status; Health; Healthy aging; Mortality; Social determinants; Socioeconomic

A 5-day high-fat diet rich in cottonseed oil improves cholesterol profiles and triglycerides compared to olive oil in healthy men.
Polley KR, Oswell NJ, Pegg RB, Paton CM, Cooper JA.
Nutr Res. 2018 Dec;60:43-53. doi: 10.1016/j.nutres.2018.09.001. Epub 2018 Sep 9.
PMID: 30527259
https://sci-hub.tw/10.1016/j.nutres.2018.09.001
Abstract
Modifying dietary fat composition is important for minimizing cardiovascular disease risk. The purpose of this study was to determine the effects of a 5-day, high-fat diet rich in cottonseed oil (CSO) or olive oil (OO) on lipid profiles. Based on previous human and animal models, we hypothesized that the CSO-rich diet would lead to lower fasting and postprandial lipid levels, whereas the OO-rich diet would not significantly change lipid levels in 5 days. Fifteen normal-weight men completed a randomized crossover design with 2 controlled feeding trials (3-day lead-in diet, prediet visit, 5-day CSO- or OO-rich diet, postdiet visit). The 5-day diets (50% fat) were rich in either CSO or OO. At pre- and postdiet visits, subjects consumed test meals rich in the oil that coincided with their 5-day diet, and blood draws were performed. Fasting total cholesterol, low-density lipoprotein cholesterol, and triglycerides (TG) were lower following CSO diet intervention (total cholesterol: 148.40 ± 6.39 to 135.93 ± 6.31 mg/dL; low-density lipoprotein cholesterol: 92.20 ± 5.57 to 78.13 ± 5.60 mg/dL; TG: 80.11 ± 4.91 to 56.37 ± 5.46 mg/dL for pre- to postdiet, respectively; P < .05). High-density lipoprotein cholesterol increased following CSO diet intervention (46.67 ± 2.41 to 50.24 ± 2.20 mg/dL for pre- to postdiet, respectively; P < .05). Postprandial TGs were lower following CSO diet (area under the curve of 954.28 ± 56.90 vs 722.16 ± 56.15 mg/dL/8 h for pre- vs postdiet, respectively; P < .01). No changes in blood lipids were found following OO diet. A 5-day CSO-rich diet led to improvements in cholesterol and TGs, whereas no changes were observed with an OO-rich diet.
KEYWORDS:
Cholesterol; Cottonseed oil; Lipids; Monounsaturated fat; Olive oil; Polyunsaturated fat; Postprandial

Dietary changes and cognition over 2 years within a multidomain intervention trial-The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).
Lehtisalo J, Levälahti E, Lindström J, Hänninen T, Paajanen T, Peltonen M, Antikainen R, Laatikainen T, Strandberg T, Soininen H, Tuomilehto J, Kivipelto M, Ngandu T.
Alzheimers Dement. 2018 Nov 23. pii: S1552-5260(18)33560-X. doi: 10.1016/j.jalz.2018.10.001. [Epub ahead of print]
PMID: 30527596
https://www.alzheimersanddementia.com/article/S1552-5260(18)33560-X/pdf
Abstract
INTRODUCTION:
Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age.
METHODS:
We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60-77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed.
RESULTS:
Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined).
DISCUSSION:
Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition.
KEYWORDS:
Cognitive performance; Diet; Growth curve analysis; Older adults; Prevention

Sleep duration and risk of end-stage renal disease: the Singapore Chinese Health Study.
Geng TT, Jafar TH, Yuan JM, Koh WP.
Sleep Med. 2018 Oct 24;54:22-27. doi: 10.1016/j.sleep.2018.10.007. [Epub ahead of print]
PMID: 30529773
Abstract
OBJECTIVES:
Although epidemiological evidence suggests that short sleep duration may affect renal function, the influence of long sleep and risk of end-stage renal disease (ESRD) is unclear. We examined the association between sleep duration and risk of ESRD.
METHODS:
We investigated sleep duration and ESRD risk in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese in Singapore, who were aged 45-74 years at recruitment (1993-1998). Information on daily sleep duration (including naps), diet, medical history and other lifestyle factors was collected at recruitment from in-person interviews. ESRD cases were identified via linkage with the nationwide Singapore Renal Registry through year 2014. We used the Cox proportional hazards regression method to estimate hazard ratio (HR) and 95% confidence interval (CI) of ESRD in relation to sleep duration.
RESULTS:
After an average 16.8 years of follow-up, 1143 (1.81%) ESRD cases were documented. Sleep duration had a U-shaped association with risk of ESRD (P for quadratic trend < 0.001). Compared with participants with 7 h/day of sleep, the multivariable adjusted HR (95% CI) of ESRD was 1.43 (1.18-1.74) for short sleep (≤5 h/day) and 1.28 (1.03-1.60) for long sleep duration (≥9 h/day). The increased risk was stronger in participants with more than 10 years of follow-up compared to those with shorter follow-up time, especially for long sleep (P for interaction = 0.003).
CONCLUSIONS:
Our findings demonstrated that both short and long sleep durations were associated with a higher risk of ESRD in this Asian population.

Plasma concentration of trimethylamine-N-oxide and risk of gestational diabetes mellitus.
Li P, Zhong C, Li S, Sun T, Huang H, Chen X, Zhu Y, Hu X, Peng X, Zhang X, Bao W, Shan Z, Cheng J, Hu FB, Yang N, Liu L.
Am J Clin Nutr. 2018 Sep 1;108(3):603-610. doi: 10.1093/ajcn/nqy116.
PMID: 30535087
Abstract
BACKGROUND:
The microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been reported as a novel and independent risk factor for the development of cardiovascular and metabolic diseases, but the association with gestational diabetes mellitus (GDM) remains unclear.
OBJECTIVE:
The aim of this study was to investigate the association between plasma TMAO concentration and GDM in a 2-phase study.
DESIGN:
A 2-phase design was used in the current study. An initial phase included 866 participants (433 GDM cases and 433 matched controls) with fasting blood samples collected at the time of GDM screening (24-32 wk of gestation). An independent-phase study, with 276 GDM cases and 552 matched controls who provided fasting blood samples before 20 wk of gestation and who had GDM screened during 24-32 wk of gestation, was nested within a prospective cohort study. These 2 studies were both conducted in Wuhan, China, and the incidence of GDM in the cohort study was 10.8%. Plasma TMAO concentrations were determined by stable isotope dilution liquid chromatography-tandem mass spectrometry. GDM was diagnosed according to the American Diabetes Association criteria by using an oral-glucose-tolerance test.
RESULTS:
In the initial case-control study, the adjusted OR of GDM comparing the highest TMAO quartile with the lowest quartile was 1.94 (95% CI: 1.28, 2.93). Each SD increment of ln-transformed plasma TMAO was associated with 22% (95% CI: 5%, 41%) higher odds of GDM. In the nested case-control study, women in the highest quartile also had increased odds of GDM (adjusted OR: 2.06; 95% CI: 1.28, 3.31) compared with women in the lowest quartile, and the adjusted OR for GDM per SD increment of ln-transformed plasma TMAO was 1.26 (95% CI: 1.08, 1.47).
CONCLUSIONS:
Consistent findings from this 2-phase study indicate a positive association between plasma TMAO concentrations and GDM. Future studies are warranted to elucidate the underlying mechanisms. 

Food groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials.
Schwingshackl L, Hoffmann G, Iqbal K, Schwedhelm C, Boeing H.
Am J Clin Nutr. 2018 Sep 1;108(3):576-586. doi: 10.1093/ajcn/nqy151.
PMID: 30535089
Abstract
BACKGROUND:
In previous meta-analyses of prospective observational studies, we investigated the association between food groups and risk of chronic disease.
OBJECTIVE:
The aim of the present network meta-analysis (NMA) was to assess the effects of these food groups on intermediate-disease markers across randomized intervention trials.
DESIGN:
Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following food groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined.
RESULTS:
A total of 66 randomized trials (86 reports) comparing 10 food groups and enrolling 3595 participants was identified. Nuts were ranked as the best food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%).
CONCLUSION:
The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other food groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role.

Sucralose decreases insulin sensitivity in healthy subjects: a randomized controlled trial.
Romo-Romo A, Aguilar-Salinas CA, Brito-Córdova GX, Gómez-Díaz RA, Almeda-Valdes P.
Am J Clin Nutr. 2018 Sep 1;108(3):485-491. doi: 10.1093/ajcn/nqy152.
PMID: 30535090
Abstract
BACKGROUND:
Recently, the absence of metabolic effects from nonnutritive sweeteners has been questioned.
OBJECTIVE:
The aim of this study was to evaluate the effects of sucralose consumption on glucose metabolism variables.
DESIGN:
We performed a randomized controlled trial involving healthy subjects without comorbidities and with a low habitual consumption of nonnutritive sweeteners (n = 33/group).
METHODS:
The intervention consisted of sucralose consumption as 15% of Acceptable Daily Intake every day for 14 d using commercial sachets. The control group followed the same procedures without any intervention. The glucose metabolism variables (insulin sensitivity, acute insulin response to glucose, disposition index, and glucose effectiveness) were evaluated by using a 3-h modified intravenous-glucose-tolerance test before and after the intervention period.
RESULTS:
Individuals assigned to sucralose consumption showed a significant decrease in insulin sensitivity with a median (IQR) percentage change of -17.7% (-29.3% to -1.0%) in comparison to -2.8% (-30.7% to 40.6%) in the control group (P= 0.04). An increased acute insulin response to glucose from 577 mU · L-1· min (350-1040 mU · L-1· min) to 671 mU · L-1· min (376-1010 mU · L-1· min) (P = 0.04) was observed in the sucralose group for participants with adequate adherence.
CONCLUSIONS:
Sucralose may have effects on glucose metabolism, and our study complements findings previously reported in other trials. Further studies are needed to confirm the decrease in insulin sensitivity and to explore the mechanisms for these metabolic alterations.

Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women.
Wang Z, Bergeron N, Levison BS, Li XS, Chiu S, Jia X, Koeth RA, Li L, Wu Y, Tang WHW, Krauss RM, Hazen SL.
Eur Heart J. 2018 Dec 10. doi: 10.1093/eurheartj/ehy799. [Epub ahead of print]
PMID: 30535398
Abstract
AIMS:
Carnitine and choline are major nutrient precursors for gut microbiota-dependent generation of the atherogenic metabolite, trimethylamine N-oxide (TMAO). We performed randomized-controlled dietary intervention studies to explore the impact of chronic dietary patterns on TMAO levels, metabolism and renal excretion.
METHODS AND RESULTS:
Volunteers (N = 113) were enrolled in a randomized 2-arm (high- or low-saturated fat) crossover design study. Within each arm, three 4-week isocaloric diets (with washout period between each) were evaluated (all meals prepared in metabolic kitchen with 25% calories from protein) to examine the effects of red meat, white meat, or non-meat protein on TMAO metabolism. Trimethylamine N-oxide and other trimethylamine (TMA) related metabolites were quantified at the end of each diet period. A random subset (N = 13) of subjects also participated in heavy isotope tracer studies. Chronic red meat, but not white meat or non-meat ingestion, increased plasma and urine TMAO (each >two-fold; P < 0.0001). Red meat ingestion also significantly reduced fractional renal excretion of TMAO (P < 0.05), but conversely, increased fractional renal excretion of carnitine, and two alternative gut microbiota-generated metabolites of carnitine, γ-butyrobetaine, and crotonobetaine (P < 0.05). Oral isotope challenge revealed red meat or white meat (vs. non-meat) increased TMA and TMAO production from carnitine (P < 0.05 each) but not choline. Dietary-saturated fat failed to impact TMAO or its metabolites.
CONCLUSION:
Chronic dietary red meat increases systemic TMAO levels through: (i) enhanced dietary precursors; (ii) increased microbial TMA/TMAO production from carnitine, but not choline; and (iii) reduced renal TMAO excretion. Discontinuation of dietary red meat reduces plasma TMAO within 4 weeks.

Rice intake and risk of type 2 diabetes: the Singapore Chinese Health Study.
Seah JYH, Koh WP, Yuan JM, van Dam RM.
Eur J Nutr. 2018 Dec 10. doi: 10.1007/s00394-018-1879-7. [Epub ahead of print]
PMID: 30535795
Abstract
PURPOSE:
The prevalence of type 2 diabetes (T2D) is increasing in Asian populations. White rice is a common staple food in these populations and results from several studies suggest that high white rice consumption increases T2D risk. We assessed whether rice, noodles and bread intake was associated with T2D risk in an ethnic Chinese population.
METHODS:
We included data from 45,411 male and female Chinese participants of the Singapore Chinese Health Study cohort aged 45-74 years at baseline. Usual diet at baseline was evaluated by a validated 165-item semi-quantitative food frequency questionnaire. Physician-diagnosed T2D was self-reported during two follow-up interviews. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS:
During a mean follow-up of 11 years, 5207 incident cases of T2D were documented. Rice intake was not associated with higher T2D risk [HR for extreme quintiles, 0.98 (95% CI 0.90, 1.08)] despite the large variation in intake levels (median intake for extreme quintiles: 236.5 g/day vs. 649.3 g/day), although the precise risk estimate depended greatly on the substitute food. Replacing one daily serving of rice with noodles [HR 1.14 (95% CI 1.07, 1.22)], red meat [HR 1.40 (95% CI 1.23, 1.60)] and poultry [HR 1.37 (95% CI 1.18, 1.59)] was associated with higher T2D risk, whereas the replacement of rice with white bread [HR 0.90 (95% CI 0.85, 0.94)] or wholemeal bread [HR 0.82 (95% CI 0.75, 0.90)] was associated with lower T2D risk.
CONCLUSIONS:
Higher rice consumption was not substantially associated with a higher risk of T2D in this Chinese population. Recommendations to reduce high white rice consumption in Asian populations for the prevention of T2D may only be effective if substitute foods are considered carefully.
KEYWORDS:
Bread; Grains; Noodles; Refined grains; Rice; Type 2 diabetes

Parrot Genomes and the Evolution of Heightened Longevity and Cognition.
Wirthlin M, Lima NCB, Guedes RLM, Soares AER, Almeida LGP, Cavaleiro NP, Loss de Morais G, Chaves AV, Howard JT, Teixeira MM, Schneider PN, Santos FR, Schatz MC, Felipe MS, Miyaki CY, Aleixo A, Schneider MPC, Jarvis ED, Vasconcelos ATR, Prosdocimi F, Mello CV.
Curr Biol. 2018 Nov 28. pii: S0960-9822(18)31417-9. doi: 10.1016/j.cub.2018.10.050. [Epub ahead of print]
PMID: 30528582
Abstract
Parrots are one of the most distinct and intriguing groups of birds, with highly expanded brains [1], highly developed cognitive [2] and vocal communication [3] skills, and a long lifespan compared to other similar-sized birds [4]. Yet the genetic basis of these traits remains largely unidentified. To address this question, we have generated a high-coverage, annotated assembly of the genome of the blue-fronted Amazon (Amazona aestiva) and carried out extensive comparative analyses with 30 other avian species, including 4 additional parrots. We identified several genomic features unique to parrots, including parrot-specific novel genes and parrot-specific modifications to coding and regulatory sequences of existing genes. We also discovered genomic features under strong selection in parrots and other long-lived birds, including genes previously associated with lifespan determination as well as several hundred new candidate genes. These genes support a range of cellular functions, including telomerase activity; DNA damage repair; control of cell proliferation, cancer, and immunity; and anti-oxidative mechanisms. We also identified brain-expressed, parrot-specific paralogs with known functions in neural development or vocal-learning brain circuits. Intriguingly, parrot-specific changes in conserved regulatory sequences were overwhelmingly associated with genes that are linked to cognitive abilities and have undergone similar selection in the human lineage, suggesting convergent evolution. These findings bring novel insights into the genetics and evolution of longevity and cognition, as well as provide novel targets for exploring the mechanistic basis of these traits.
KEYWORDS:
Amazona aestiva; Psittaciformes; cognition; evolution; genome; genomics; longevity; parrot; telomerase; ultraconserved elements

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Sedentary leisure-time in relation to mortality and survival time.
Larsson SC, Wolk A.
J Sci Med Sport. 2018 Nov 28. pii: S1440-2440(18)30282-2. doi: 10.1016/j.jsams.2018.11.020. [Epub ahead of print]
PMID: 30522752
Abstract
OBJECTIVE:
To examine the association between sedentary leisure-time and all-cause mortality and differences in survival time.
DESIGN:
Prospective cohort study.
METHODS:
Information on sedentary leisure-time, defined as TV viewing and/or sitting reading, was collected from 72003 Swedish adults who were 45-83 (median 60) years of age and completed a self-administered questionnaire at baseline and were followed up for 17years through linkage with the Swedish Death Register.
RESULTS:
The association between sedentary leisure-time and all-cause mortality was modified by age with a more pronounced association in middle-aged (<60years of age) than in older adults (≥60years of age) (p-interaction<0.001). During follow-up, 3358 and 15217 deaths occurred in the middle-aged and older age group, respectively. The multivariable-adjusted hazard ratios for the highest (>6h/day) versus lowest category (<1h/day) of sedentary leisure-time were 1.72 (95% confidence interval [CI] 1.29-2.30) in middle-aged adults and 1.19 (95% CI 1.05-1.36) in older adults. This corresponded to a difference in survival time of respectively 2.4 (95% CI -4.1 to -0.8) years and 1.5 (95% CI -2.2 to -0.7) years.
CONCLUSIONS:
Prolonged sedentary leisure-time was associated with a significantly decreased survival time up to 2.4 years in middle-aged adults.
KEYWORDS:
Cohort studies; Mortality; Sedentary leisure-time; Survival; TV viewing

Can the design of a running shoe help prevent injury? A B.C. researcher says he has the answer
Barefoot? Big sole? For years, runners have been getting conflicting advice about the ideal shoe
Kelly Crowe · CBC News · Posted: Dec 15, 2018
https://www.cbc.ca/news/health/running-shoe-injury-prevention-second-opinion-1.4947408
"One study reported that in a single year about 50 per cent of all runners will suffer knee injuries, or other running-related problems including plantar fasciitis, Achilles tendinopathy and stress fractures of the foot and the tibia."

Growth Signaling and Longevity in Mouse Models.
Kim SS, Lee CK.
BMB Rep. 2018 Dec 14. pii: 4454. [Epub ahead of print]
PMID: 30545442
Abstract
Reduction of insulin/insulin-like growth factor 1 (IGF1) signaling (IIS) extends the lifespan of various species. So far, several longevity mouse models have been developed containing mutations related to growth signaling deficiency by targeting growth hormone (GH), IGF1, IGF1 receptor, insulin receptor, and insulin receptor substrate. In addition, p70 ribosomal protein S6 kinase 1 (S6K1) knockout leads to lifespan extension. S6K1 encodes an important kinase in the regulation of cell growth. S6K1 is regulated by mechanistic target of rapamycin (mTOR) complex 1. The v-myc myelocytomatosis viral oncogene homolog (MYC)-deficient mice also exhibits a longevity phenotype. The gene expression profiles of these mice models have been measured to identify their longevity mechanisms. Here, we summarize our knowledge of long-lived mouse models related to growth and discuss phenotypic characteristics, including organ-specific gene expression patterns.

Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis.
Gjuladin-Hellon T, Davies IG, Penson P, Amiri Baghbadorani R.
Nutr Rev. 2018 Dec 13. doi: 10.1093/nutrit/nuy049. [Epub ahead of print]
PMID: 30544168
Abstract
CONTEXT:
Carbohydrate-restricted diets may increase low-density lipoprotein cholesterol and thereby cardiovascular risk.
OBJECTIVE:
A systematic review and meta-analyses were conducted to compare the effects of very low, low, and moderate carbohydrate, higher fat diets versus high-carbohydrate, low-fat diets on low-density lipoprotein cholesterol and other lipid markers in overweight/obese adults.
DATA SOURCES:
Medline, PubMed, Cochrane Central, and CINAHL Plus were searched to identify large randomized controlled trials (n > 100) with duration ≥ 6 months.
DATA EXTRACTION:
Eight randomized controlled trials (n = 1633; 818 carbohydrate-restricted diet, 815 low-fat diet) were included.
DATA ANALYSIS:
Quality assessment and risk of bias, a random effects model, and sensitivity and subgroup analyses based on the degree of carbohydrate restriction were performed using Cochrane Review Manager. Results were repor
RESULTS:
Carbohydrate-restricted diets showed no significant difference in low-density lipoprotein cholesterol after 6, 12, and 24 months. Although an overall pooled analysis statistically favored low-fat diets (0.07 mmol/L; 95% confidence interval [CI], 0.02-0.13; P = 0.009], this was clinically insignificant. High-density lipoprotein cholesterol and plasma triglycerides at 6 and 12 months favored carbohydrate-restricted diets (0.08 mmol/L; 95%CI, 0.06-0.11; P < 1 × 10-5 and -0.13 mmol/L; 95%CI, -0.19 to -0.08; P < 1 × 10-5, respectively). These favorable changes were more marked in the subgroup with very-low carbohydrate content (< 50 g/d; 0.12 mmol/L; 95%CI, 0.10-0.14; P < 1 × 10-5 and -0.19 mmol/L; 95%CI, -0.26 to -0.12; P = 0.02, respectively).
CONCLUSIONS:
Large randomized controlled trials of at least 6 months duration with carbohydrate restriction appear superior in improving lipid markers when compared with low-fat diets. Dietary guidelines should consider carbohydrate restriction as an alternative dietary strategy for the prevention/management of dyslipidemia for populations with cardiometabolic risk.

Dietary intake of nutrients involved in folate-mediated one-carbon metabolism and risk for endometrial cancer.
Lu J, Trabert B, Liao LM, Pfeiffer RM, Michels KA.
Int J Epidemiol. 2018 Dec 13. doi: 10.1093/ije/dyy270. [Epub ahead of print]
PMID: 30544261
Abstract
BACKGROUND:
Studies disagree as to whether intakes of folate-mediated one-carbon metabolism nutrients are associated with endometrial cancer.
METHODS:
Using data from the large, prospective NIH-AARP Diet and Health Study, we used Cox proportional hazards models to evaluate endometrial cancer risk associated with calorie-adjusted dietary intake of several B vitamins and methionine. All models accounted for age, race, body mass index (BMI), smoking, oral-contraceptive use, menopausal hormone therapy use and caloric intake. We estimated associations by time from baseline (≤3 or >3 years) and stratified models by BMI (<25 or ≥25 kg/m2). During 16 years of follow-up, we identified 2329 endometrial cancer cases among 114 414 participants.
RESULTS:
After adjustment for confounding, we observed increased risk for endometrial cancer with greater consumption of dietary total folate, natural folate, B2, B6 and B12 [hazard ratios (HRs) ranging from 1.14 to 1.24 for the highest quintile (Q5) vs the lowest (Q1)]. Higher intakes of total folate, natural folate, B6 and B12 continued to be associated with increased risk when limiting follow-up to >3 years from baseline. We observed risks for the highest intakes of B2 [Q5 vs Q1: HR 1.27 95% confidence interval (CI) 1.07-1.50], B12 (Q5 vs Q1: HR 1.38 CI 1.17-1.63) and methionine (Q5 vs Q1: HR 1.26 CI 1.07-1.48) among women who were overweight/obese, but not among normal/underweight women.
CONCLUSIONS:
Our findings indicate that one-carbon metabolism plays a role in endometrial carcinogenesis and exploration of this role in tissue and cellular biology studies is warranted.

Dietary Fat Intake and Risk of Colorectal Cancer: A Systematic Review and Meta-Analysis of Prospective Studies.
Kim M, Park K.
Nutrients. 2018 Dec 12;10(12). pii: E1963. doi: 10.3390/nu10121963. Review.
PMID: 30545042
Abstract
Dietary fat intake is associated with the risk of colorectal cancer (CRC); however, the results of epidemiological studies on this are controversial. Therefore, this study aimed to summarize the available scientific evidence regarding the association between dietary fat and the risk of CRC. We conducted a systematic search of PubMed, Web of Science, and the Cochrane library for articles related to dietary fat and the risk of CRC. The summary relative risks with 95% confidence intervals (CI) were calculated via a random effect model. Begg's test was used to detect publication bias. A total of 18 articles were identified. The pooled relative risk with 95% CI for the risk of CRC were 1.00 (95% CI: 0.90⁻1.12), 0.97 (95% CI: 0.86⁻1.10), 1.08 (95% CI: 0.92⁻1.26), and 0.99 (95% CI: 0.93⁻1.04) for total fat, saturated fatty acid, monounsaturated fatty acid, and polyunsaturated fatty acid, respectively. No significant associations were found in subgroup analyses. Begg's test for all exposures revealed no publication bias (total fat, p = 0.3; saturated fatty acid, p = 0.1; monounsaturated fatty acid, p = 0.08; polyunsaturated fatty acid, p = 0.2). The studies included in this review and meta-analysis revealed that dietary fats and fatty acids had no effects on the risk of CRC.
KEYWORDS:
colorectal neoplasms; dietary fats; fatty acids; meta-analysis; systematic review

Calcium intake and survival after colorectal cancer diagnosis.
Yang W, Ma Y, Smith-Warner SA, Song M, Wu K, Wang M, Chan AT, Ogino S, Fuchs CS, Poylin V, Ng K, Meyerhardt JA, Giovannucci EL, Zhang X.
Clin Cancer Res. 2018 Dec 13. pii: clincanres.2965.2018. doi: 10.1158/1078-0432.CCR-18-2965. [Epub ahead of print]
PMID: 30545821
Abstract
PURPOSE:
Although evidence suggests an inverse association between calcium intake and colorectal cancer incidence, the influence of calcium on survival after colorectal cancer diagnosis remains unclear.
EXPERIMENTAL DESIGN:
We prospectively assessed the association of postdiagnostic calcium intake with colorectal cancer-specific and overall mortality among 1,660 non-metastatic colorectal cancer patients within the Nurses' Health Study and the Health Professionals Follow-up Study. Patients completed a validated food frequency questionnaire between 6 months and 4 years after diagnosis and were followed up for death. Multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards regression.
RESULTS:
Comparing the highest to the lowest quartile intake of postdiagnostic total calcium, the multivariable HRs were 0.56 (95% CI, 0.32 to 0.96, P trend = 0.04) for colorectal cancer-specific mortality and 0.80 (95% CI, 0.59 to 1.09, P trend = 0.11) for all-cause mortality. Postdiagnostic supplemental calcium intake was also inversely associated with CRC-specific mortality (HR = 0.67; 95% CI, 0.42 to 1.06; P trend = 0.047) and all-cause mortality (HR = 0.71; 95% CI, 0.54 to 0.94; P trend = 0.008), although these inverse associations were primarily observed in women. In addition, calcium from diet or dairy sources was associated with lower risk in men.
CONCLUSIONS:
Higher calcium intake after the diagnosis may be associated with a lower risk of death among patients with colorectal cancer. If confirmed, these findings may provide support for the nutritional recommendations of maintaining sufficient calcium intake among colorectal cancer.

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